Original Article
 

The Effect of Oral Montelukast in Controlling Asthma Attacks in Children: A Randomized Double-blind Placebo Control Study

Abstract

Oral Montelukast is recommended as maintenance therapy for persistent asthma, but there is controversy regarding its effectiveness in controlling asthma attacks. The present study was conducted to investigate the clinical efficacy of oral Montelukast for asthma attacks in children.
This study was conducted as a double-blind placebo-controlled clinical trial on 80 children aged 1-14 years with asthma who were admitted to the emergency department of Bahrami Children's Hospital (Tehran, Iran) during one year. Patients were randomly divided into case and control groups. In addition to the standard asthma attack treatment, Montelukast was prescribed in the case group and placebo in the control group for one week. Patients were evaluated in terms of asthma attack severity score and oxygen saturation percentage (SpO2) in room air as primary outcomes 1, 4, 8, 24 and 48 hours after admission.
In the first 48 hours, there was no significant difference in the score of asthma attack severity and SpO2 between the case and control groups. There was no significant difference between the groups in terms of length of hospitalization or number of admissions to the intensive care unit. None of the patients were re-hospitalized after discharge.
The results of this study showed that the use of Montelukast along with the standard treatment of asthma attacks in children has no added benefit.

1. Dharmage SC, Perret JL, Custovic A. Epidemiology of Asthma in Children and Adults. Front. Pediatr. 2019;7:246.
2. Ferrante G, La Grutta S. The Burden of Pediatric Asthma. Front. Pediatr. 2018;6:186.
3. Pearce N, Aït-Khaled N, Beasley R, Mallol J, Keil U, Mitchell E, Robertson C, and the ISAAC Phase Three Study Group. Worldwide trends in the prevalence of asthma symptoms: phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2007;62:758-66.
4. Soto-Martínez ME, Soto-Quiros ME, Custovic A. Childhood Asthma: Low and Middle-Income Countries Perspective. Acta Med Acad. 2020;49(2):181-90.
5. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2021. A
6. Carr TF, Bleecker E. Asthma heterogeneity and severity. World Allergy Organ J. 2016;29;9(1):41.
7. Bonato M, Tiné M, Bazzan E, Biondini D, Saetta M, Baraldo S. Early Airway Pathological Changes in Children: New Insights into the Natural History of Wheezing. J Clin Med. 2019;8(8):1180.
8. Pijnenburg MW, Frey U, De Jongste JC, Saglani S. Childhood asthma: pathogenesis and phenotypes. Eur Respir J. 2022 9;59(6):2100731.
9. Comberiati P, Di Cicco ME, D'Elios S, Peroni DG. How Much Asthma Is Atopic in Children? Front Pediatr. 2017;5(3):122.
10. Di Cicco M, D'Elios S, Peroni DG, Comberiati P. The role of atopy in asthma development and persistence. Curr Opin Allergy Clin Immunol. 2020;20(2):131-137.
11. Caminati M, Pham DL, Bagnasco D, Canonica GW. Type 2 immunity in asthma. World Allergy Organ J. 2018;11(1):13.
12. Jo-Watanabe A, Okuno T, Yokomizo T. The Role of Leukotrienes as Potential Therapeutic Targets in Allergic Disorders. Int J Mol Sci. 2019 Jul 22;20(14):3580.
13. Trinh HKT, Lee SH, Cao TBT, Park HS. Asthma pharmacotherapy: an update on leukotriene treatments. Expert Rev Respir Med. 2019 Dec;13(12):1169-78.
14. Marcello C, Carlo L. Asthma phenotypes: the intriguing selective intervention with Montelukast. Asthma Res Pract. 2016;2:11.
15. Tesse R, Borrelli G, Mongelli G, Mastrorilli V, Cardinale F. Treating Pediatric Asthma According Guidelines. Front Pediatr. 2018;6(5)234.
16. Nagao M, Ikeda M, Fukuda N, Habukawa C, Kitamura T, Katsunuma T, Fujisawa T; LePAT (Leukotriene and Pediatric Asthma Translational Research Network) investigators. Early control treatment with montelukast in preschool children with asthma: A randomized controlled trial. Allergol Int. 2018;67(1):72-8.
17. Ramsay CF, Pearson D, Mildenhall S, Wilson AM. Oral montelukast in acute asthma exacerbations: a randomised, double-blind, placebo-controlled trial. Thorax. 2011 Jan;66(1):7-11.
18. Chaudhury A, Gaude GS, Hattiholi J. Effects of oral montelukast on airway function in acute asthma: A randomized trial. Lung India. 2017;34(4):349-54.
19. Wang X, Zhou J, Zhao X, Yi X. Montelukast Treatment of Acute Asthma Exacerbations in Children Aged 2 to 5 Years: A Randomized, Double-Blind, Placebo-Controlled Trial. Pediatr Emerg Care. 2018 Mar;34(3):160-4.
20. Harmanci K, Bakirtas A, Turktas I, Degim T. Oral montelukast treatment of preschool-aged children with acute asthma. Ann Allergy Asthma Immunol. 2006;96(5):731-5.
21. Magazine R, Surendra VU, Chogtu B. Comparison of oral montelukast with oral ozagrel in acute asthma: A randomized, double-blind, placebo-controlled study. Lung India. 2018 Jan-Feb;35(1):16-20.
22. Green SA, Malice MP, Tanaka W, Tozzi CA, Reiss TF. Increase in urinary leukotriene LTE4 levels in acute asthma: correlation with airflow limitation. Thorax. 2004 Feb;59(2):100-4.
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IssueVol 22 No 5 (2023) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijaai.v22i5.13990
Keywords
Asthma attack Children Montelukast

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How to Cite
1.
Jafari M, Sobhani M, Eftekhari K, Malekiantaghi A, Gharagozlou M, Shafiei A. The Effect of Oral Montelukast in Controlling Asthma Attacks in Children: A Randomized Double-blind Placebo Control Study. Iran J Allergy Asthma Immunol. 2023;22(5):413-419.