Effects of montelukast on subjective and objective outcome measures in preschool asthmatic children.
It is well accepted that control of airway inflammation is crucial for overall asthma control. Hence, efficient anti-inflammatory therapy is important for disease control. Therefore, we studied the effect of a treatment with montelukast on subjective and objective measures in preschool asthmatic children with insufficient control of airway inflammation, illustrated by increased fractional exhaled nitric oxide (FeNO). Thirty-one preschool children (2.5-5 years) were included in this study. Children with FeNO > or = 10 ppb at the first visit received montelukast 4 mg as a first line therapy or an add-on therapy to their baseline treatment (group 1). Therapy was not changed at first visit in children with FeNO < 10 ppb (group 2). Symptom scores, FeNO, lung function (forced oscillation, Rrs8Hz) and airway responsiveness to adenosine 5'-monophosphate (AMP) were assessed at visits 1 and 2 eight weeks apart. There was a significant decrease in FeNO (median [interquartile range]; 12.9 [3.7] vs. 7.6 [6.85] ppb, P = 0.011), Rrs8Hz (mean +/- SD; 10.03 +/- 3.1 vs. 8.72 +/- 2.43 hPa.s/L; P = 0.047) and symptom scores (2[2] vs. 1.5[2], P = 0.034) and a significant increase in the provocative AMP dose (2.65 +/- 2.1 vs. 4.54 +/- 1.05; P = 0.015) in group 1 but not in group 2. First line or add-on treatment of oral montelukast in preschool children with mild to moderate asthma and elevated FeNO, decreased levels of FeNO, improved airway responsiveness to AMP, lung function and symptom scores.
Moeller
Alexander
A
Swiss Pediatric Respiratory Research Group, Division of Respiratory Medicine, University Children's Hospital Zurich, Zürich, Switzerland.
Lehmann
Andrea
A
Knauer
Nicola
N
Albisetti
Manuela
M
Rochat
Mascha
M
Johannes
Wildhaber
W
D000085:Acetates / Q000627:therapeutic use*; D000249:Adenosine Monophosphate / Q000378:metabolism; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology*; D002675:Child, Preschool; D003521:Cyclopropanes; D045853:Exhalation; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007223:Infant; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism*; D011446:Prospective Studies; D011804:Quinolines / Q000627:therapeutic use*; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D013147:Spirometry; D013440:Sulfides; D016896:Treatment Outcome; D014797:Vital Capacity
D000085:Acetates; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D009569:Nitric Oxide; D000249:Adenosine Monophosphate; C093875:montelukast