The efficacy of montelukast during the allergy season in pediatric patients with persistent asthma and seasonal aeroallergen sensitivity.
OBJECTIVE
To determine the effect of montelukast on asthma during the allergy season in children with persistent asthma and seasonal aeroallergen sensitivity.


METHODS
This 3-week double-blind, placebo-controlled, parallel-group multicenter study compared daily montelukast 5 mg chewable tablets and placebo in patients 6-14 years of age with forced expiratory volume in 1 second (FEV(1)) > or = 60 and < or = 85% predicted, persistent asthma that is also active during allergy season, and documented sensitivity to seasonal allergens. Concomitant inhaled corticosteroid use was permitted in up to 40% of enrolled patients. The primary endpoint was the percentage change from baseline in FEV(1) over 3 weeks of treatment. Additional endpoints included the percentage change from baseline in beta-agonist use, average changes in daytime and nighttime symptom score, AM and PM peak expiratory flow rate (PEFR), investigator's global asthma evaluation, and parent/guardian global asthma evaluation at the end of the treatment period. Adverse experiences (AEs) were collected to assess safety and tolerability.


RESULTS
A total of 421 patients were randomized to montelukast (N = 203) or placebo (N = 218). For the primary endpoint, the percentage change from baseline FEV(1), montelukast was not significantly different from placebo (least squares mean 9.53% vs. 9.15%, respectively; p = 0.810). Compared with placebo, montelukast was associated with significantly lower (better) investigator's global asthma evaluation (LS mean 2.71 vs. 2.98; p < 0.05) and parent/guardian global asthma evaluation (LS mean: 2.63 vs. 2.90; p < 0.05) scores. There were no significant differences between treatment groups for the other efficacy evaluations. Both treatments were well tolerated, with no significant differences observed in AE rates.


CONCLUSIONS
Montelukast did not significantly improve FEV(1) compared with placebo over three weeks of treatment during the allergy season in pediatric patients with seasonal allergen sensitivity. (ClinicalTrials.gov identifier: NCT00289874).
Papadopoulos
Nikolaos G
NG
Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece. ngp@allergy.gr
Philip
George
G
Giezek
Hilde
H
Watkins
Molly
M
Smugar
Steven S
SS
Polos
Peter G
PG
D000085:Acetates / Q000008:administration & dosage*; D000284:Administration, Oral; D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D002648:Child; D018592:Cross-Over Studies; D003521:Cyclopropanes; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D015999:Multivariate Analysis; D011336:Probability; D011379:Prognosis; D011804:Quinolines / Q000008:administration & dosage*; D012016:Reference Values; D012129:Respiratory Function Tests; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis* / Q000276:immunology; D018570:Risk Assessment; D012720:Severity of Illness Index; D013440:Sulfides; D016896:Treatment Outcome
D000085:Acetates; D003521:Cyclopropanes; D011804:Quinolines; D013440:Sulfides; C093875:montelukast