title: Effects of montelukast on subjective and objective outcome measures in preschool asthmatic children.
abstract: 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.
authors: Swiss Pediatric Respiratory Research Group, Division of Respiratory Medicine, University Children's Hospital Zurich, Zürich, Switzerland.
authors: Alexander
authors: A
authors: Moeller
authors: Andrea
authors: A
authors: Lehmann
authors: Nicola
authors: N
authors: Knauer
authors: Manuela
authors: M
authors: Albisetti
authors: Mascha
authors: M
authors: Rochat
authors: Wildhaber
authors: W
authors: Johannes
mesh_terms: 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
chemical_list: D000085:Acetates; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D009569:Nitric Oxide; D000249:Adenosine Monophosphate; C093875:montelukast