title: Montelukast for bronchiolitis obliterans syndrome after lung transplantation: a pilot study.
abstract: Bronchiolitis obliterans syndrome (BOS) remains the major hurdle to improve long-term survival after lung transplantation, as its treatment remains troublesome. In this pilot study, we investigated the effect of montelukast (a leukotriene receptor antagonist) on the FEV(1) decline after diagnosis of BOS and compared this with a control group. In both groups, 11 patients were included with BOS stage <3 and bronchoalveolar lavage (BAL) neutrophilia <15%, already being treated or concurrently being started on azithromycin. Control patients were selected retrospectively. After adding montelukast (10 mg/day) to the immunosuppressive regimen, the FEV(1) decline significantly decreased from 112 ± 26 ml/month before BOS diagnosis to 13 ± 13 ml/month after 6 months of montelukast therapy (P = 0.001). In the control group, there was no significant change in the rate of FEV(1) decline: 103 ± 20 ml/month before BOS diagnosis to 114 ± 27 ml/month (P = 0.55). Adding montelukast may be a promising treatment option in patients with low neutrophilic (<15%) BOS after lung transplantation, already or concurrently being treated with azithromycin.
authors.affiliation: Lung Transplantation Unit, University Hospital Gasthuisberg, Leuven, Belgium. geert.verleden@uzleuven.be
authors.forename: Geert M
authors.initials: GM
authors.lastname: Verleden
authors.forename: Stijn E
authors.initials: SE
authors.lastname: Verleden
authors.forename: Robin
authors.initials: R
authors.lastname: Vos
authors.forename: Stéphanie I
authors.initials: SI
authors.lastname: De Vleeschauwer
authors.forename: Lieven J
authors.initials: LJ
authors.lastname: Dupont
authors.forename: Dirk E
authors.initials: DE
authors.lastname: Van Raemdonck
authors.forename: Bart M
authors.initials: BM
authors.lastname: Vanaudenaerde
mesh_terms: D000085:Acetates / Q000627:therapeutic use*; D017963:Azithromycin; D001989:Bronchiolitis Obliterans / Q000188:drug therapy* / Q000503:physiopathology; D003521:Cyclopropanes; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011804:Quinolines / Q000627:therapeutic use*; D013440:Sulfides; D016896:Treatment Outcome
chemical_list: D000085:Acetates; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D017963:Azithromycin; C093875:montelukast