Efficacy Of Montelukast Research Articles

The Efficacy of Montelukast in Reducing the Risk of Warning Signs and Subsequent Dengue Shock Syndrome in Adult Dengue Fever Patients.

Dengue fever continues to pose significant health challenges globally, with recent outbreaks in Bihar, India, prompting a search for effective therapeutic interventions. This study assesses the effectiveness of Montelukast, traditionally used for asthma, in mitigating the severity of dengue fever symptoms and its progression to dengue shock syndrome (DSS). To evaluate the impact of Montelukast on the prevalence of dengue warning signs and the incidence of DSS in adult patients. A prospective observational study was conducted at the Indira Gandhi Institute of Medical Sciences(IGIMS), Patna, India, from August 2022 to October 2023, enrolling 500 patients diagnosed with dengue fever. Participants were divided into two groups. About 250 were treated with Montelukast and 250 received standard care. Outcomes measured included the incidence of warning signs, DSS, length of hospital stay, and 30-day mortality. The Montelukast group exhibited a 24% lower prevalence of dengue warning signs compared to the control group, with 90 out of 250 patients (36%) in the Montelukast group versus 150 out of 250 patients (60%) in the control group (p < 0.001). The incidence of DSS was significantly reduced in the Montelukast group, with 4 out of 250 patients (1.6%) compared to 21 out of 250 patients (8.4%) in the control group (odds ratio: 0.178, p < 0.001). Furthermore, Montelukast users experienced shorter hospital stays (average 4.52 days vs. 6.54 days, T-statistic: -7.59, p = 1.58×10-13) and a reduced 30-day mortality rate, with 5 out of 250 patients (2%) in the Montelukast group versus 12 out of 250 patients (5%) in the control group (p < 0.03). Montelukast significantly lowers the incidence of dengue warning signs and DSS, shortens hospital stays, and decreases mortality rates among dengue patients, supporting its potential integration into existing dengue treatment protocols. This study highlights the need for further clinical trials to confirm these findings and fully understand the therapeutic mechanisms of Montelukast in dengue management.

THE ROLE OF MONTELUKAST IN MANAGEMENT OF CHILDREN WITH COVID-19 INFECTION

Management of coronavirus infection especially in children is a continuous process of constant updating.&nbsp; It is difficult find the date about effect of montelukast in children with Covid-19 infection. According of this, the aim of the present article was to review the role of montelukast that could be beneficial in management of children with covid-19 infection. 76 patients (2 to 18 years of age, 43 girls, 33 boys) with the symptoms of dry and lingering cough were involved in the study. According to treatment design, the patients were divided into treatment groups. One part of the group was prescribed only inhalers, one part ‒ leukotriene receptor antagonists, one part ‒ antihistamines and the last one ‒ all three antihistamines simultaneously, respectively. Follow-up showed that the clinical effect of dry cough was more pronounced in patients administering montelukast only or in combination in comparison with the children taking only local glucocorticosteroid and antihistamines, such as desloratadine or levocetirizine separately, on a selective basis. The obtained results indicate the efficacy of montelukast, as symptomatic agents, for the treatment of Covid-19 patients with a dry and lingering cough. Research monitoring has also confirmed the ancillary effect of montelukast in children with Covid-19 infection.&nbsp

Addition of a nutraceutical to montelukast or inhaled steroid in the treatment of wheezing during COVID-19 pandemic: a multicenter, open-label, randomized controlled trial.

Background and aim:Recurrent wheezing is often triggered by viral respiratory infections. The aims of our study were: i) to evaluate whether the addition of a nutraceutical (Leucodif®), could improve the efficacy of montelukast or inhaled steroids (ICS) compared to the single treatment; ii) to verify whether a treatment is more effective than another. Our study was biased by the COVID-19 pandemic, which resulted in a lockdown of almost two months in Italy.Methods:The multicenter, open-label study enrolled 84 children aged 2–6 years diagnosed with recurrent wheezing and randomized them into four treatment arms for three months: ICS treatment; ii) montelukast; iii) montelukast + Leucodif; iv) ICS + Leucodif. Children were assessed at baseline and after one, two, and three months of treatment using the TRACK score for both the caregiver and the physician.Results:Out of the 84 patients, 18 patients received ICS therapy, 22 patients ICS + Leucodif, 24 patients montelukast, and 20 patients montelukast + Leucodif. All four treatments resulted in a significant reduction in symptoms with no differences among the various groups.Conclusions:Our study demonstrates that montelukast therapy appears to be equally effective as ICS therapy and that the addition of the nutraceutical Leucodif does not appear to improve the treatment outcome. However, in our opinion our study was strongly influenced and biased by the lockdown due to the COVID-19 pandemic, which inherently resulted in reduced exposure to the viruses that commonly cause respiratory infections in children. (www.actabiomedica.it)

Efficacy of montelukast in preventing seasonal recurrence of vernal keratoconjunctivitis in children.

Vernal keratoconjunctivitis is a chronic, seasonally exacerbated, allergic inflammation of the eye. The study aims to evaluate the efficacy and safety of oral montelukast in treating vernal keratoconjunctivitis in pediatric patients. This is a 26-week, prospective, randomized, open-label study. Fifty-eight patients were randomly assigned to two groups-the treatment (montelukast) and control groups. At the beginning of the study, both the groups received topical loteprednol etabonate (0.1%) in tapering doses for a month, and topical olopatadine (0.1%) for the first 3 months. Symptoms and signs observed before and after treatment and assigned scores were studied. The primary efficacy endpoint was change in the mean score on the visual analog scale (VAS) for each subjective symptom. The secondary efficacy endpoint was change in the total score of objective signs. The montelukast group showed clinically relevant improvements in the signs and symptoms of vernal keratoconjunctivitis, compared to the control group. There was considerable improvement in clinical signs. Individual symptoms such as redness, itching, foreign body sensation, and tearing showed significant improvement at 6 months follow-up. The gradual improvement in symptoms until the last visit was statistically more significant within montelukast group. Mean VAS score showed statistically significant improvement in itching (p < 0.001) and redness (p < 0.008) in montelukast group even at 3 months. No adverse events were reported in either group. Montelukast was found to be safe and effective as a long-term therapy to prevent relapse in moderate to severe vernal keratoconjunctivitis.

The relevance of CYSLTR1 gene polymorphism to the severity of allergic rhinitis and clinical responsiveness of montelukast in children.

The etiology of allergic rhinitis (AR) is closely correlated with the complex interactions between genetic and environmental factors. This study explored the effect of single-nucleotide polymorphisms (SNPs) of CYSLTR1 gene on the risk of AR and clinical response to montelukast treatment in children. A total of 135 children with AR and 100 healthy children were included for subsequent analyses. Genotype and allele distribution of rs321029 SNP of CYSLTR1 gene and inflammatory mediators were detected and compared between AR and healthy children. Genotype and allele frequency of rs321029 SNP of CYSLTR1 gene showed no difference between children with AR and controls or between AR cases with different severity. The total montelukast effective rate of wide-type genotype TT children was significantly higher than variants genotype CC children. Polymorphism of rs321029 on CYSLTR1 gene is not related to the susceptibility and severity of AR in children, but it is closely related with the efficacy of montelukast on AR.

Efficacy of Montelukast in Allergic Rhinitis Treatment: A Systematic Review and Meta-Analysis.

In treating allergic rhinitis, montelukast has the potential to be used as an alternative or addition to an oral antihistamine or intranasal corticosteroid. The objective of this systematic review was to assess the effectiveness of montelukast in treating allergic rhinitis. An electronic literature search was performed using the Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE from 1966 to 21 January 2019. The eligibility criteria were randomized controlled trials comparing montelukast with placebo or other standard treatments. The primary outcomes assessed were daytime nasal symptom score (DNS) and night-time nasal symptom score (NNS). The secondary outcomes assessed were composite nasal symptom score (CSS), daytime eyes symptom score (DES), and rhinoconjunctivitis quality-of-life questionnaires (RQLQ). The meta-analysis was conducted using Review Manager 5.3 software based on the random-effects model. Fifteen studies of 10387 participants met the inclusion criteria. Montelukast was more effective than placebo in improving DNS (mean difference [MD] - 0.12, 95% confidence interval [CI] - 0.15 to - 0.08; p < 0.001), NNS (MD - 0.09, 95% CI - 0.13 to - 0.05; p < 0.001), CSS (MD - 0.08, 95% CI - 0.11 to - 0.06; p < 0.001), DES (MD - 0.17, 95% CI - 0.33 to - 0.02; p < 0.030), and RQLQ (MD - 0.34, 95% CI - 0.49 to - 0.20; p < 0.001). Oral antihistamine was superior to montelukast in improving DNS (MD 0.08, 95% CI 0.03-0.13; p = 0.002), CSS (MD 0.03, 95% CI - 0.02 to 0.07; p = 0.27), DES (MD 0.06, 95% CI 0-0.12; p = 0.040), and RQLQ (MD 0.03, 95% CI - 0.05 to 0.12; p = 0.430). Montelukast was superior to oral antihistamine in improving NNS (MD -0.03, 95% CI - 0.08 to 0.03; p = 0.330). Intranasal fluticasone spray was superior to montelukast in improving DNS (MD 0.71, 95% CI 0.44-0.99; p < 0.001) and NNS (MD 0.63, 95% CI 0.29-0.97; p < 0.001). Combined montelukast and oral antihistamine was superior to oral antihistamine in improving DNS (MD - 0.15, 95% CI - 0.27 to - 0.03; p = 0.010), NNS (MD - 0.16, 95% CI - 0.28 to - 0.05; p = 0.006), CSS (MD - 0.12, 95% CI - 0.25 to - 0.01; p = 0.070), DES (MD - 0.12, 95% CI - 0.30 to 0.06; p = 0.180), and RQLQ (MD - 0.10, 95% CI - 0.28 to 0.08; p = 0.290). Combined montelukast and OAH was superior to montelukast in improving DNS (MD 0.15, 95% CI 0.08-0.21; p < 0.001), NNS (MD 0.05, 95% CI - 0.09 to 0.19; p = 0.510), CSS (MD 0.1, 95% CI 0.03-0.17; p = 0.007), DES (MD 0.18, 95% CI 0-0.36; p = 0.050), and RQLQ (MD 0.07 95% CI - 0.15 to 0.29; p = 0.530). Montelukast is more effective than placebo in treating the overall symptoms of allergic rhinitis while the combined therapy of montelukast and an oral antihistamine is superior to either montelukast or an oral antihistaminealone.

Efficacy of Montelukast in Reducing the Incidence and Severity of Monoclonal Antibodies Associated Infusion Reactions

Efficacy of Montelukast in Reducing the Incidence and Severity of Monoclonal Antibodies Associated Infusion Reactions

Evaluation the Safety and Efficacy of Montelukast in Treatment of Patients With Fatty Liver Disease

Evaluation the Safety and Efficacy of Montelukast in Treatment of Patients With Fatty Liver Disease

Comparison of the efficacy of montelukast or ketotifen combined with salmeterol/fluticasone in the treatment of cough variant asthma

Objective To compare the efficacy of montelukast or ketotifen combined with salmeterol/fluticasone powder inhalation in the treatment of cough variant asthma. Methods From July 2016 to July 2017, 74 patients with cough-variant asthma admitted to the 903rd Hospital of People's Liberation Army Joint Service Support Unit were selected.According to the random number table method, the patients were randomly divided into the control group and observation group, with 37 patients in each group.All patients were treated with inhalation of salmeterol/fluticasone, with montelukast chewable tablets in the observation group, and ketotifen tablets in the control group.The adverse reactions in the two groups after treatment were recorded, and the treatment effect and typical asthma conversion rate in the two groups were compared. Results The total effective rate of the observation group was 94.59%, which was significantly higher than 78.38% of the control group (χ2=8.283, P 0.05). In the observation group, 2 patients had nausea, and 2 patients had laryngopharyngeal discomfort.In the control group, 1 patient had laryngopharyngeal discomfort, 2 patients had dizziness, and 3 patients had somnolence.All the above symptoms were mild and could be relieved after symptomatic treatment.After 1 year of follow-up, the recurrence rate of the observation group was 27.03%, which was significantly lower than 43.24% of the control group (χ2=8.072, P<0.05). After 1 year of follow-up, the typical asthma conversion rate of the observation group was 21.62%, which was significantly lower than 37.84% of the control group (χ2=7.322, P<0.05). Conclusion Montelukast in the treatment of cough variant asthma can greatly reduce the recurrence rate and the conversion rate of typical asthma.It is not only safe but also effective.It is worthy of popularizing in clinic. Key words: Asthma; Cough; Montelukast; Ketotifen; Salmeterol; Flixonase; Asthma; Treatment outcome; Recurrence

Математико-статистическая оценка влияния монтелукаста на клиническую эффективность противоастматической терапии у детей

Математико-статистическая оценка влияния монтелукаста на клиническую эффективность противоастматической терапии у детей

Efficacy of Montelukast as Prophylactic Treatment for Seasonal Allergic Rhinitis

The evidence supporting the prophylactic treatment of seasonal allergic rhinitis before the start of pollen dispersal is still lacking. We conducted a study to investigate the efficacy of prophylaxis with montelukast for seasonal allergic rhinitis and to evaluate its influence on the inflammatory condition of the lower airway. Our final study population was made up of 57 adults who were randomized to a prophylactic treatment group and a control group. The prophylaxis group was made up of 31 patients-10 men and 21 women, aged 18 to 54 years (mean: 36.9)-who were administered montelukast for 2 weeks before the cypress pollen season and subsequently throughout the remainder of the season. The control group was made up of 26 patients-11 men and 15 women, aged 24 to 63 years (mean: 39.2)-who took montelukast during the pollen season only. During the pollen season, the mean daily rescue medication score was significantly lower in the prophylaxis group (3.22 vs. 3.89; p = 0.001). However, there was no statistical difference in the two groups' mean daily rhinoconjunctivitis symptom scores. Also, the fraction of exhaled nitric oxide in the prophylaxis group tended to be lower than that of control group, but again the difference was not significant (29.8 vs. 42.1 ppb; p = 0.189). We conclude that antileukotriene prophylaxis started 2 weeks before the cypress pollen dispersal was effective in reducing the need for rescue medication during the pollen season and showed a trend toward alleviating the eosinophilic inflammation in the lower airway induced by the pollen.

Efficacy of Montelukast and Ranitidine as an Add on Therapy for Chronic Urticaria

Efficacy of Montelukast and Ranitidine as an Add on Therapy for Chronic Urticaria

The Efficacy of Montelukast in Adjunct with Amoxicillin in Treatment of Acute Otitis Media (AOM) in Children

BackgroundAcute otitis media (AOM) is very common in children. In spite of spontaneously relief, some cases suffer from the recurrence and other complications occurring after AOM. Animal studies have proved that persistence of leukotrienes in the middle ear may play a role in the development of AOM. Based on this statement, treatment with leukotriene modifiers may be effective in the treatment of OM. The aim of this study was to examine the effect of adjunction of to antibacterial agents in treatment of AOM.Materials and MethodsOne hundred patients aged 2-6 years were randomly divided into two groups. One of the groups (53%) were treated with alone, 80-90 mg/kg amoxicillin for 10 days, and the other group (47%), received and montelukast 5 mg per day orally for 10 days. Patients were evaluated for resolution and complications of AOM at 2 post enrollment visits (days 2-4 and 10-14).ResultsThe patient followed-up for one month and results showed that, treatment with had beneficial effects on resolution of AOM. In monotherapy (amoxicillin alone) group, 66% of patients and in the (amoxicillin and montelukast) group, 85.1% were treated.ConclusionIn this study, the receiving group showed a better response to treatment. Based on this and previous studies, it is recommended to consider the role of inflammatory mediators in AOM. Prescribing and other leukotriene receptor antagonists may have benefits for the patients.

Efficacy of add-on montelukast in nonasthmatic eosinophilic bronchitis: the additive effect on airway inflammation, cough and life quality.

Background:The efficacy of montelukast (MONT), a cysteinyl leukotriene receptor antagonist, in nonasthmatic eosinophilic bronchitis (NAEB), especially its influence on cough associated life quality is still indefinite. We evaluated the efficacy of MONT combined with budesonide (BUD) as compared to BUD monotherapy in improving life quality, suppressing airway eosinophilia and cough remission in NAEB.Methods:A prospective, open-labeled, multicenter, randomized controlled trial was conducted. Patients with NAEB (aged 18-75 years) were randomized to inhaled BUD (200 μg, bid) or BUD plus oral MONT (10 μg, qn) for 4 weeks. Leicester cough questionnaire (LCQ) life quality scores, cough visual analog scale (CVAS) scores, eosinophil differential ratio (Eos), and eosinophil cationic protein (ECP) in induced sputum were monitored and compared.Results:The control and MONT groups contained 33 and 32 patients, respectively, with similar baseline characteristics. Significant with-in group improvement in CVAS, LCQ scores, Eos, and ECP was observed in both groups during treatment. After 2-week treatment, add-on treatment of MONT was significantly more effective than BUD monotherapy for CVAS decrease and LCQ scores improvement (both P < 0.05). Similar results were seen at 4-week assessment (both P < 0.05). 4-week add-on therapy of MONT also resulted in a higher percentage of patients with normal sputum Eos (<2.5%) and greater decrease of ECP (both P < 0.05).Conclusions:MONT combined with BUD was demonstrated cooperative effects in improvement of life quality, suppression of eosinophilic inflammation, and cough remission in patients with NAEB.

The clinical efficacy of montelukast in the treatment of cough caused by mycoplasma pneumonia infection in children

Objective To investigate the clinical efficacy of montelukast sodium chewable tablets in the treatment of cough caused by mycoplasma pneumonia infection in children.Methods 160 children with cough caused by mycoplasma pneumonia infection in our department from 2011 to 2013 were randomly divided into group A and B,80 cases in each group.Children in group B received conventional antibiotic therapy and symptomatic and supportive treatment and care,children in group A received montelukast treatment on the basis of group B.Cough remission in children was observed 3 days,1 week,2 weeks after treatment.Results The rate of cough remission in two groups rose accompanied by the increase of treatment time.The rates of cough remission 3 days,1 week,2 weeks after treatment in group A were higher than those in group B,with statistically significant differences (x2 =11.374-15.227,P ＜ 0.05).Conclusion Montelukast in the treatment of children with cough caused by mycoplasma pneumonia infection can shorten course of disease and promote rehabilitation of children. Key words: Montelukast; Mycoplasma pneumoniae; Treatment; Cough

Real-life effectiveness of montelukast administered as monotherapy or in combination with inhaled corticosteroid (ICS) in pediatric patients with uncontrolled asthma

Background The efficacy of montelukast in the treatment of asthma has been demonstrated in numerous controlled clinical trials. The aim of this study was to assess the real-life effectiveness of montelukast administered as monotherapy or in combination with current ICS in children with uncontrolled asthma. Methods Results Among the 328 patients included, 76 (23.2%) were treated with montelukast monotherapy and 252 (76.8%) with montelukast combined with ICS. By 4 weeks of treatment 61.3% and 52.9% of patients in the monotherapy and com- bination group, respectively, achieved asthma control. These proportions increased to 75.0% and 70.9%, respectively, at week-12. Clinically and statistically (P<0.001) significant improvements were observed in ACQ (monotherapy: mean (SD) of 1.67 (0.69) at baseline and 0.50 (0.52) at week-12; combination therapy: 2.02 (0.83) and 0.64 (0.86), respectively) and PACQLQ (mono- therapy: mean (SD) of 5.34 (1.14) at baseline and 6.51 (0.85) at week-12; combination therapy: 4.42 (1.35) and 6.21 (1.03), respectively) in both patient subgroups. After a 12-week montelukast add-on therapy, 22.6% of patients reduced their ICS dosage. Conclusions Montelukast as monotherapy or in combination with ICS represents an effective treatment strategy for achieving asthma control in pediatric patients and improving caregivers' quality of life.

The efficacy of montelukast as a protective agent against 131I-induced salivary gland damage in rats

This study was designed to evaluate the efficiency of montelukast as a novel radioprotective agent against sodium [131I]iodide or potassium [131I]iodide (131I)-induced salivary gland damage in a rat model. The function and structure of salivary glands in 50 albino Wistar rats were evaluated with technetium-99m pertechnetate scintigraphies and histopathological examination. The animals were classified into five groups as follows: the control group (sham operated); group 1 (n=10; only 131I administration), group 2 (n=10; administration with 131I and montelukast); group 3 (n=10; 131I administration after total thyroidectomy); and group 4 (n=10; administration with 131I and montelukast after total thyroidectomy). All rats were killed at the end of the third month and three pairs of salivary glands were removed surgically. The scintigraphic evaluation revealed better results for groups administered montelukast than it did for other groups. Statistically significant differences (P<0.05 or P<0.001) were found between the control group and the other groups as well as between groups 1 and 3 (n=20) and groups 2 and 4 (n=20). However, there was no statistically significant difference (P>0.05) between groups 1 and 2 (n=20) and groups 3 and 4 (n=20). Histopathological examinations showed that pathological changes were significantly high in the groups treated with 131I without montelukast when compared with the other groups. This is the first study on rats to assess the protective effect of montelukast on salivary glands after 131I therapy. According to our results, montelukast was found to be a potential protective agent against 131I-induced damage on salivary glands.

Responsiveness to leukotriene D4 and methacholine for predicting efficacy of montelukast in asthma.

A lower responsiveness to leukotriene D4 (LTD4) or higher LTD4/[methacholine (MCh)] potency ratio might suggest preferable outcomes of short-term montelukast monotherapy in terms of airway inflammation and lung function in asthmatic patients.

Allergic diseases of the skin and drug allergies – 2021. Efficacy of montelukast as add-on therapy in patients with chronic idiopathic urticaria

Methods Patients who received montelukast for CIU between 2008-2011 (4-year period) were retrospectively identified from clinic letters. Clinical features of duration of urticaria, medication use, autoimmunity and laboratory investigations that included basopenia and mean platelet volume on full blood count, complement levels, specific IgE, autoimmune serology [antinuclear antibody (ANA), thyroid peroxidase antibodies, serum histamine releasing antibody (using donor basophils, positive >18.5%)] were collected and analysed. The primary end point was adequate control of urticaria without additional therapy. Patients with features of urticarial vasculitis and those who required corticosteroids or immunosuppressants were excluded. Nonparametric statistical data were calculated using GraphPad Prism software.

Safety and efficacy of montelukast as adjunctive therapy for treatment of asthma in elderly patients

Asthma is a disease of all ages. This assumption has been challenged in the past, because of several cultural and scientific biases. A large body of evidence has accumulated in recent years to confirm that the prevalence of asthma in the most advanced ages is similar to that in younger ages. Asthma in the elderly may show similar functional and clinical characteristics to that occurring in young adults, although the frequent coexistence of comorbid conditions in older patients, together with age-associated changes in the human lung, may lead to more severe forms of the disease. Management of asthma in the elderly follows specific guidelines that apply to all ages, although most behaviors are pure extrapolation of what has been tested in young ages. In fact, age has always represented an exclusion criterion for eligibility to clinical trials. This review focuses specifically on the safety and efficacy of leukotriene modifiers, which represent a valid option in the treatment of allergic asthma, both as an alternative to first-line drugs and as add-on treatment to inhaled corticosteroids. Available studies specifically addressing the role of montelukast in the elderly are scarce; however, leukotriene modifiers have been demonstrated to be safe in this age group, even though cases of acute hepatitis and occurrence of Churg-Strauss syndrome have been described in elderly patients; whether this is associated with age is to be confirmed. Furthermore, leukotriene modifiers provide additional benefit when added to regular maintenance therapy, not differently from young asthmatics. In elderly patients, the simpler route of administration of leukotriene modifiers, compared with the inhaled agents, could represent a more effective strategy in improving the outcomes of asthma therapy, given that unintentional nonadherence with inhalation therapy represents a complex problem that may lead to significant impairment of asthma symptom control.