Montelucast (singulair®) Affects Bronchial And Nasal Reactivity Induced By Allergen Challenge

Abstract

RATIONALE: We intended to see the effect of Singulair® (Montelucast) on bronchial and nasal reactivity induced by bronchial and nasal challenges with cat allergen extract in cat allergic volunteers.METHODS: The volunteers underwent 4 sessions, 2 consisting bronchial and two nasal challenges. Each session needed three visit days D0, D6 and D7. On D0, NSBHR to methacholine was measured. Volunteers took the study drug, Singulair or placebo, from D0 to D6. On D6 challenge was performed. eNO was measured on D0, D6 (before and after challenge, 3 and 6 hours post challenge) and on D7 (24 hours post challenge). NSBHR was re-measured 3 hours post nasal challenge on D6.RESULTS: 26 volunteers participated in the study. Allergen BCT was evaluable in 25 volunteers. Fel d1 PD20 was significantly higher after the treatment with Singulair (2.464 μg) than with placebo (0.607 μg) (p <0.001) and eNO values were significantly lower immediately after, 3 and 6 hours post challenge. Allergen nasal challenge tests were evaluable in 23 volunteers. The dose inducing a positive reaction in terms of either reduction in nasal flow or increase in resistance was not different between two treatments. However, symptom score was significantly lower (p= 0.02) after Singulair than after placebo. The NSBHR did not modify after the nasal challenge and eNO values did not differ between two treatment groups.CONCLUSIONS: Singulair significantly reduces the bronchial reactivity. It significantly lowers the symptom score during nasal challenge. The NSBHR does not seem to modify after nasal allergen challenge. RATIONALE: We intended to see the effect of Singulair® (Montelucast) on bronchial and nasal reactivity induced by bronchial and nasal challenges with cat allergen extract in cat allergic volunteers. METHODS: The volunteers underwent 4 sessions, 2 consisting bronchial and two nasal challenges. Each session needed three visit days D0, D6 and D7. On D0, NSBHR to methacholine was measured. Volunteers took the study drug, Singulair or placebo, from D0 to D6. On D6 challenge was performed. eNO was measured on D0, D6 (before and after challenge, 3 and 6 hours post challenge) and on D7 (24 hours post challenge). NSBHR was re-measured 3 hours post nasal challenge on D6. RESULTS: 26 volunteers participated in the study. Allergen BCT was evaluable in 25 volunteers. Fel d1 PD20 was significantly higher after the treatment with Singulair (2.464 μg) than with placebo (0.607 μg) (p <0.001) and eNO values were significantly lower immediately after, 3 and 6 hours post challenge. Allergen nasal challenge tests were evaluable in 23 volunteers. The dose inducing a positive reaction in terms of either reduction in nasal flow or increase in resistance was not different between two treatments. However, symptom score was significantly lower (p= 0.02) after Singulair than after placebo. The NSBHR did not modify after the nasal challenge and eNO values did not differ between two treatment groups. CONCLUSIONS: Singulair significantly reduces the bronchial reactivity. It significantly lowers the symptom score during nasal challenge. The NSBHR does not seem to modify after nasal allergen challenge.