The effect of montelukast on exhaled nitric oxide and lung function in asthmatic children 2 to 5 years old.
OBJECTIVE
The study was undertaken to investigate the influence of once-daily treatment with montelukast (Singulair; MSD; Glattbrugg, Switzerland) on levels of exhaled nitric oxide (eNO) and lung function in preschool children with asthma.


METHODS
A total of 30 children (19 girls), 2 to 5 years of age, in whom asthma had been newly diagnosed, who had a positive first-degree family history of asthma and a positive allergy test result, were allocated to undergo a 1-week run-in period of montelukast treatment. eNO and airway resistance were measured in all patients before (visit 1) and after the run-in period (visit 2), and after treatment with montelukast (4 mg once daily) for 4 weeks (visit 3).


RESULTS
There were no significant differences in all parameters before and after the run-in period. However, the mean (SD) levels of eNO and the mean (SD) levels of airway resistance after treatment at visit 3 were 11.6 parts per billion (ppb) [9.5 ppb] and 1.15 kPa/L/s (0.26 kPa/L/s), respectively, and were significantly lower compared to values of 33.1 ppb (12.0 ppb) and 1.28 kPa/L/s (0.23 kPa/L/s), respectively, before treatment (p < 0.001) and at visit 2 (p = 0.01). There was no significant change in mean bronchodilator responsiveness between visit 3 (13.2%; SD, 6.8%) and visit 1/visit 2 (13.3%; SD, 7.0%; p = 0.47).


CONCLUSIONS
We have shown that montelukast has a positive effect on lung function and airway inflammation as measured by nitric oxide level in preschool children with allergic asthma.
Straub
Daniel A
DA
Division of Respiratory Medicine, University Children's Hospital, Steinwiesstrasse 75, CH-8032 Zürich, Switzerland. daniel.straub@kispi.unizh.ch
Minocchieri
Stefan
S
Moeller
Alexander
A
Hamacher
Jürg
J
Wildhaber
Johannes H
JH
D000085:Acetates / Q000009:adverse effects / Q000627:therapeutic use*; D000403:Airway Resistance / Q000187:drug effects* / Q000502:physiology; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D001944:Breath Tests; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002675:Child, Preschool; D003521:Cyclopropanes; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D020024:Leukotriene Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009569:Nitric Oxide / Q000502:physiology*; D011804:Quinolines / Q000009:adverse effects / Q000627:therapeutic use*; D011852:Radioallergosorbent Test; D012130:Respiratory Hypersensitivity / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D013440:Sulfides; D013726:Terbutaline / Q000627:therapeutic use; D016896:Treatment Outcome
D000085:Acetates; D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D009569:Nitric Oxide; C093875:montelukast; D013726:Terbutaline