Efficacy and compliance of montelukast as prophylaxis in mild persistent asthma

Abstract

Background: Bronchial Asthma is characterized by hyperresponsiveness of airways to various triggers. The management goals of asthma therapy are to control asthma so that the affected child can lead a normal life without asthma exacerbations. In spite of several advances in the management aspects, asthma morbidity remains the same. Under diagnosis, inappropriate therapy and poor compliance are the major contributors to asthma morbidity. In the recent years the knowledge about different clinical and biological phenotypes of asthma has helped in deciding the treatment options in bronchial asthma. Montelukast has proven to be particularly effective in exercise induced asthma and asthma associated with allergic rhinitis. The aim of this study is to assess the efficacy and compliance of montelukast for prophylaxis in mild persistent asthma in children aged 1-12 years.Methods: This is a prospective study which included children between age group 1-12 years with mild persistent asthma who was started on montelukast during the 12-month period from September 2016 to October 2017. No. of children who were controlled with moutelukast and who needed step up treatment were noted. Comorbidities of children who were controlled on montelukast were also studied.Results: At the end of 6 months, 86.4% of children were well controlled and 13.6% were not well controlled.91.5% who were well controlled belonged to 1-5 years age group. Children with comorbidities like allergic rhinitis had good control with moutelukast. Response to montelukast was good when viral infection was a trigger.Conclusions: It is a safe drug with modest benefits in bronchial asthma. It is useful in mild persistent asthma where ICS administration is impractical and also in patients with comorbidities like allergic rhinitis. It is also found to decrease the episode of viral induced wheeze in young children.