[Montelukast-free interval before inhalational bronchial allergen provocation].
BACKGROUND
Leukotrienes are potent bronchoconstrictive and proinflammatory mediators in bronchial asthma. In a previous study on 16 subjects with bronchial asthma (two randomized groups) we showed that montelukast (10 mg daily) significantly suppressed allergen provocation with specific allergens (mites and pollen) (p = 0.0005). In a follow-up study we addressed the question as to when montelukast should be discontinued in order to avoid a relevant effect on inhalational bronchial allergen provocation.


METHODS
At the end of the first study montelukast (10 mg daily) was given again to both groups (2 x 8 asthma patients) for 21 days. After a montelukast-free period of one and three days allergen provocation was repeated in the same manner and the results were compared with the historic baseline values without montelukast.


RESULTS
The provocation dose for allergens was reduced by 39% after a montelukast-free period of one day and by 67% after three days. Only after three days was the difference significant (p = 0.017), at which time the control value was nearly reached again.


CONCLUSIONS
We recommend that montelukast be discontinued at least three days prior to inhalational allergen provocation.
Riffelmann
F-W
FW
Fachkrankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmung und Schlafmedizin, Allergologie, Schmallenberg. f.riffelmann@fkkg.de
Droste
G
G
Lauter
H
H
Köhler
D
D
D000085:Acetates / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D000485:Allergens; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001985:Bronchial Provocation Tests / Q000379:methods*; D003521:Cyclopropanes; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D011804:Quinolines / Q000008:administration & dosage* / Q000627:therapeutic use; D015203:Reproducibility of Results; D013440:Sulfides; D013997:Time Factors
D000085:Acetates; D000485:Allergens; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D011804:Quinolines; D013440:Sulfides; C093875:montelukast