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SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
11/9/06
Is montelukast steroid sparing in childhood asthma?
Summary
Background – Montelukast (Mont), a leukotriene receptor antagonist, has been reported to be effective as add-on treatment to inhaled corticosteroid (ICS) therapy in persistent asthma (PA) in adults. The ICS dosage may be lowered in some patients in such combination therapy. Are such effects of Mont treatment seen in PA in children?
Findings – Jat et al of the Post Graduate Institute in Chandigarh, India compared treatment with inhaled budesonide, 400 mcg/day alone (Bud 400) vs Bud 200 mcg/day plus Mont 5 mg/day (Bud 200/Mont 5) in 71 children with moderate PA.
After 12 weeks of treatment they found that the median FEV-1, PEFR and Asthma Symptom Scores were not significantly different in the 2 treatment groups. However, the frequency of acute asthma exacerbations was significantly higher in the patients treated with Bud 200/Mont (33%) than in patients treated with Bud 400.
Reference
Ann Allergy Asthma Immunol 2006;97:397-401
Editor's Comments
The authors of this report concluded that treatment with Bud 400 was superior to therapy with Bud 200/Mont 5 in their study patients. This impression is different than that of studies comparing an ICS alone with 50% of the dose of that ICS along with inhaled salmeterol or formoterol (LABA). Indeed, side by side comparisons have concluded that inhaled LABA are more effective than Mont as add-on therapy to ICS in the management of moderate PA.
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