Abstract
International guidelines recommend the use of inhaled corticosteroids (ICSs) as the preferred therapy, with leukotriene receptor antagonists (LTRAs) as an alternative, for the management of persistent asthma in children. Montelukast (MLK) is the first LTRA approved by the Food and Drug Administration for the use in young asthmatic children.Therefore, we performed an analysis of studies that compared the efficacy of MLK versus ICSs. We considered eligible for the inclusion randomized, controlled trials on pediatric populations with Jadad score > 3, with at least 4 weeks of treatment with MLK compared with ICS.Although it is important to recognize that ICSs use is currently the recommended first-line treatment for asthmatic children, MLK can have consistent benefits in controlling asthmatic symptoms and may be an alternative in children unable to use ICSs or suffering from poor growth. On the contrary, low pulmonary function and/or high allergic inflammatory markers require the corticosteroid use.
Highlights
International guidelines recommend the use of inhaled corticosteroids (ICSs) as the preferred therapy, with leukotriene receptor antagonists (LTRAs) as an alternative, for the management of persistent asthma in children
We have selected 16 randomized, controlled trials performed from 2001 to 2008 on pediatric populations in which LTRAs were compared to ICSs, making a distinction according to MLK efficacy in studies that observed similar results of the two drugs versus others that observed a minor efficacy of MLK compared to ICSs (Tables 1 and 2)
Not inferior efficacy of Montelukast compared to Inhaled Corticosteroids Maspero et al in a 6-month, open-label extension study compared the efficacy of oral MLK with inhaled BDP (IBDP)
Summary
International guidelines recommend the use of inhaled corticosteroids (ICSs) as the preferred therapy, with leukotriene receptor antagonists (LTRAs) as an alternative, for the management of persistent asthma in children. These eicosanoids are derived from the metabolism of membrane phospholipids within alveolar macrophages, eosinophils, mast cells and neutrophils, MLK is a selective cysteinyl - leukotriene receptor antagonist that reduces asthmatic inflammation and airway resistance and prevents bronchoconstriction [3,13,14,15] It is the most studied and used LTRA in pediatric age, being the first approved by the Food and Drug Administration (FDA) for the use in young asthmatic children, at the dosage of 4 mg for children aged from 1 to 5 years and of 5 mg for patients 6 to 14 years of age once daily [16]. A Cochrane review (last updated in January 2004) summarized the accumulating evidence derived from 13 randomized controlled trials and concluded that low doses of inhaled glucocorticoids were superior to LTRAs [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
