Montelukast treatment in children with moderately severe atopic dermatitis.
BACKGROUND
Moderately severe atopic dermatitis makes up nearly one-fifth of children with atopic dermatitis.


OBJECTIVE
To determine the clinical and laboratory effects of montelukast in moderately severe atopic dermatitis.


METHODS
Randomized, double-blind, placebo-controlled, crossover trial with washout period, conducted from May 2002 to February 2006. The study involved 25 patients, 2-16 years old with dermatitis. Patients received oral montelukast (9 patients, Group B) or placebo (16 patients, Group A) in phase 1, and were crossed over to placebo or montelukast, respectively, for phase 2. Patients included if > 10% of skin was involved and failed response to 2 week conventional treatment. Itching, sleep disturbance, frequency of use of oral antihistamines & topical steroids, severity scores were serially assessed. In addition, eosinophil and serum IgE were serially collected.


RESULTS
Most of patients were 6-10 years of age. Both groups had comparable gender distribution. The patients in Group B were more likely to have a history of bronchial asthma (55.6%) or allergic rhinitis (33.3%) than patients in Group A, but were less likely to have a positive history of atopy. While on montelukast, there was a reduction of mean score for itching in phase 2, for sleep disturbance in phase 2, for antihistamines in phase 1, for extent-of-disease in phase 1 and 2, and for severity score in phase 2 and blood eosinophil & IgE in phase 2.


CONCLUSIONS
Montelukast reduces itching, sleep disturbance, disease extent and severity, blood eosinophil count and serum IgE.
Ehlayel
M S
MS
Department of Pediatrics Allergy and Immunology, Hamad Medical Corporation.
Bener
A
A
Sabbah
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D000085:Acetates / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D000284:Administration, Oral; D001772:Blood Cell Count; D003521:Cyclopropanes; D003876:Dermatitis, Atopic / Q000097:blood / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D004334:Drug Administration Schedule; D004804:Eosinophils / Q000276:immunology / Q000473:pathology; D006634:Histamine H1 Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D011804:Quinolines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D012890:Sleep / Q000187:drug effects; D013440:Sulfides; D016896:Treatment Outcome
D000085:Acetates; D003521:Cyclopropanes; D006634:Histamine H1 Antagonists; D007073:Immunoglobulin E; C093875:montelukast; D011804:Quinolines; D013440:Sulfides