Retrospective cohort study of leukotriene receptor antagonist therapy for preventing upper respiratory infection-induced acute asthma exacerbations.
Upper respiratory tract infections (URIs) represent the most frequent cause of acute asthma exacerbations. It has yet to be determined whether leukotriene receptor antagonist (LTRA) treatment prevents URI-induced acute asthma exacerbations in adults. The objective of the present study was to evaluate the preventive effects of LTRA treatment on URI-induced acute asthma exacerbations. The incidences of URI alone, acute asthma exacerbation without URI, and URI-induced acute asthma exacerbation were determined retrospectively by analyzing diary and medical records of 321 adult asthmatic patients (mean age, 56.3 ± 17.2 years; male/female ratio, 117:204) over 1 year. Results were compared between patients who had been taking an LTRA (n = 137) and those who had never taken any LTRA (n = 184) during the study periods. Significantly fewer URIs alone and acute asthma exacerbations without URI occurred in patients with than in those without prophylactic daily use of LTRA. LTRA treatment significantly reduced the durations of URIs alone and of total acute asthma exacerbations, as well as the incidence of mild exacerbations of asthma. In contrast, in patients with URI-induced acute asthma exacerbations, LTRA treatment failed to significantly reduce the interval between URI onset and acute asthma exacerbation, as well as the duration and severity of both URIs and acute asthma exacerbations. Use of an LTRA for adult asthmatic patients appears to reduce the incidences of URIs alone and acute asthma exacerbations without URI, but it failed to prevent URI-induced acute asthma exacerbations once a URI occurred.
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Hiroto
H
Matsuse
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Tomoko
T
Tsuchida
Department of Internal Medicine, Sasebo City General Hospital, Sasebo, Japan.
Susumu
S
Fukahori
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Tetsuya
T
Kawano
Department of Internal Medicine, Isahaya Health Insurance General Hospital, Nagasaki, Japan, and.
Shinya
S
Tomari
Department of Internal Medicine, Nagasaki Municipal Hospital, Nagasaki, Japan.
Nobuko
N
Matsuo
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Tomoya
T
Nishino
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Chizu
C
Fukushima
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Shigeru
S
Kohno
Acute asthma exacerbation; bronchial asthma; inhaled corticosteroids; inhaled long-acting beta2-agonist; leukotriene receptor antagonist; montelukast; pranlukast; retrospective cohort study; short-acting beta2-agonist; upper respiratory tract infection