SELECTED ARTICLES FROM THE RECENT LITERATURE 2004

12/20/04

Montelukast treatment of chronic cough in children

Summary
Background - Previous studies (mainly in adults) have shown that persistent asthma (PA), often previously undiagnosed, is one of the more common causes of chronic cough of apparently undetermined etiology. Treatment with leukotriene antagonists such as montelukast (Mont) improves PA in at least some individuals.

Findings - Kopriva et al of the University Hospital in Olomovc, Czech Republic evaluated the effects of treatment with Mont 5 mg/day for 4 weeks in 22 children with chronic cough (CC) but no known asthma. In 14 children, the cough ceased by the third week of Mont treatment. Such children were found to have higher serum levels of eosinophil cationic protein (ECP) at baseline than did children whose CC did not improve with Mont therapy (p<0.01). The baseline total eosinophil counts and serum IgE levels were also higher in those whose CC ceased. In 2 of the 8 children whose CC did not improve with Mont treatment, evidence of gastro-esophageal reflux was found.

Reference
J Asthma 2004; 41:715-20

Editor's Comments
I have reviewed this preliminary, uncontrolled study because the provocative findings may tell us more about the relationship of PA to CC in childhood. It would be of considerable interest to see the effects of treatment with inhaled corticosteroids in these children with CC. A blinded, controller comparison of these two treatments approaches (vs placebo) is warranted.

 

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