Use Of Montelukast Research Articles

Montelukast and Neuropsychiatric Events in Children With Asthma: A Nested Case-Control Study

SD Glockler-Lauf, Y Finkelstein, J Zhu, LY Feldman, T To. J Pediatr. 2019;209:176–182.e4 To assess the association between montelukast prescription and neuropsychiatric events in children with asthma. Ontario children aged 5–18 years with an index neuropsychiatric event between April 1, 2004, and March 31, 2016, were identified as cases within a study cohort of children with physician-diagnosed asthma prescribed an asthma maintenance medication. Patients with pre-existing mental health conditions or a dispensed prescription for zafirlukast were excluded. Each case was matched based on sex, asthma diagnosis date, and birthdate to a maximum of four control patients without a neuropsychiatric event from the same study cohort. …

Isatuximab Short-Duration Fixed-Volume Infusion Plus Bortezomib (V) Lenalidomide (R) and Dexamethasone(d) Combined Therapy for Newly Diagnosed Multiple Myeloma (NDMM): Results from a Phase 1b Feasibility/Safety Study

Isatuximab Short-Duration Fixed-Volume Infusion Plus Bortezomib (V) Lenalidomide (R) and Dexamethasone(d) Combined Therapy for Newly Diagnosed Multiple Myeloma (NDMM): Results from a Phase 1b Feasibility/Safety Study

Montelukast does not increase the risk of attention-deficit/hyperactivity disorder in pediatric asthma patients: A nationwide population-based matched cohort study

Attention-deficit/hyperactivity disorder (ADHD) has been linked to pediatric asthma patients treated with montelukast. This study is the first to use a nationwide health insurance research database (NHIRD) to study whether asthmatic children using montelukast are at an increased risk of ADHD. We used data from the Taiwan NHIRD, which is a longitudinal database of one million randomly selected subjects. The enrolled patients were followed up until 2013. Patients younger than and equal to 12 years old with new-onset asthma (ICD-9 CM code 493.X) diagnosed between 1997 and 2013 were enrolled. A multivariate Cox regression analysis was conducted to evaluate the association between montelukast treatment and the risk of ADHD (ICD-9-CM code 314.X). We enrolled a total of 54,487 asthmatic children younger than and equal to 12 years old who had at least one claim of inpatient admission or at least three claims of an ambulatory visit. Montelukast users and match controls were identified by matching age, gender, residence, the comorbidities including allergic rhinitis and atopic dermatitis, admission or emergency department visits due to asthma attack, and index date of starting montelukast in a 1:1 ratio, with 12,806 in the montelukast group and 12,806 in the non-montelukast group. The montelukast group had a similar risk of ADHD (n=632, 4.94%) as the non-montelukast group (n=610, 4.76%) [adjusted hazard ratio 1.04; 95% confidence interval, 0.93 to 1.17]. In children treated with montelukast, high cumulative days of montelukast use did not increase the risk of ADHD. This nationwide population-based cohort study reveals that asthma children treated with montelukast were not at an increased risk of developing ADHD. Nevertheless, validation of our retrospective survey requires further prospective study.

A possible effect of montelukast on neurological aging examined by the use of register data

Background The leukotriene receptor antagonist montelukast has been shown to rejuvenate aged brains in rats; however, data on humans are still scarce. Objective To investigate if montelukast may alleviate degenerative neurological changes using a register data. Setting Norwegian registry data analyses. Method The present observational study was based on data from the Norwegian Prescription Database and the Tromsø Study. The former has information regarding the use of prescription medicine; the latter includes tests for brain function such as subjective memory and finger-tapping. Multivariate linear regression analyses were performed to see how the use of various medications correlated with the test results, correcting for likely confounders. Main outcome measure Results on seven different tests considered relevant for neurological health were used as outcome. Results Previous use of montelukast correlated with improved scores on cognitive or neurological functioning (F = 2.20, p = 0.03 in a multivariate test). A range of other medications were tested with the same algorithm, including drugs acting on the immune system, but none of them correlated with (overall) significantly improved test results. Conclusion The present data suggest that montelukast may alleviate degenerative neurological changes associated with human aging.

Risk of Psychiatric Adverse Events Among Montelukast Users

There have been conflicting results from observational studies regarding the risk of psychiatric adverse events (PAEs) with montelukast use. To determine whether there are associations of depressive disorders, self-harm, and suicide with use of montelukast compared with inhaled corticosteroid (ICS) use. Using data from the Sentinel Distributed Database from January 1, 2000, to September 30, 2015, patients (n= 457,377) exposed to montelukast or ICS, aged 6 years and older with a diagnosis of asthma, were matched 1:1 on propensity scores. Hazard ratios (HRs) and 95% CIs were estimated for each study outcome overall and by age, sex, psychiatric history, and pre-/post-2008 labeling updates using Cox proportional hazards regression models. Exposure to montelukast was associated with a lower risk of treated outpatient depressive disorder (HR, 0.91; 95% CI, 0.89-0.93). No increased risks of inpatient depressive disorder (HR, 1.06; 95% CI, 0.90-1.24), self-harm (HR, 0.92; 95% CI, 0.69-1.21), or self-harm using a modified algorithm (HR, 0.81; 95% CI, 0.63-1.05) were observed with montelukast use compared with ICS use. Most PAEs occurred in the roughly one-third of patients having a past psychiatric history. When compared with use of ICS, we did not find associations between montelukast use and hospitalizations for depression or self-harm events. Our findings should be interpreted considering the study's limitations. Psychiatric comorbidity was common, and most PAEs occurred in patients with a past psychiatric history.

ASSERTION FOR MONTELUKAST IN THE COVID-19 PANDEMICS?

The ongoing pandemic coronavirus disease (COVID-19) is an infection caused by a newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). The treatment of COVID-19 patients represents a continuous challenge, no vaccine or specific antiviral therapy is yet available. International guidelines recommend the medical management based only on the first line physicians' short expertise, off-label approaches being admitted worldwide to limit and to decrease the infection devastating impacts on humans’ health. A marketed drug used for asthma, known generically as montelukast, gives light in the attempt of clinicians during their efforts to combat SARS-CoV2 spreading. Even not yet approved by FDA or EMA for COVID-19 infection indication, many clinicians are raising-up the idea of turning attention and attempts to off-label medical options like montelukast use, considering this drug an alternative or additive therapeutic approach for prevention and treating pulmonary distress.

Hemorragia alveolar por montelukast: reporte de caso

La hemorragia alveolar difusa es un hallazgo clínico patológico, consecuencia de una lesión en la microcirculación pulmonar que se presenta con sintomatología inespecífica e incluso en pacientes asintomáticos. Se diferencian tres diagnósticos histopatológicos, siendo la capilaritis el más común y secundario a patologías autoinmunes. Se presenta el caso de un paciente, con hallazgo imagenológico y en lavado broncoalveolar, compatible con hemorragia alveolar difusa en quien se descartó como causa, enfermedades autoinmunes e infecciosas; durante la anamnesis, se identificó inicio reciente de montelukast, con relación temporal, respuesta a suspensión, cambio imagenológico y escalas de probabilidad de reacción adversa de Naranjo que apoya el diagnóstico.

IMPROVING METHODS OF TREATMENT OF ATOPIC PATHOLOGY IN CHILDREN

The main goal of therapy for allergic diseases is to control the symptoms of the disease, prevent relapses and reduce the risk of adverse consequences of the disease. Leukotriene receptor antagonists are an effective anti-inflammatory drug for the prevention of relapses of bronchial asthma, allergic rhinitis and atopic dermatitis in children. Long-term use of montelukast (3 months) does not increase the side effects of the drug. Based on their own experience of using montelukast drugs in children from the age of two, the use of these drugs in the treatment of allergic diseases in children significantly increased the level of control of these diseases at an early age.

Effect of Montelukast on the Symptom Severity Score of Allergic Rhinitis.

IntroductionRhinitis is a common respiratory disorder that can be broadly defined as an inflammation of nasal mucosa. Allergic rhinitis is the most common form of chronic rhinitis characterized by one or more symptoms including sneezing, nasal itching, nasal congestion, postnasal drip, and rhinorrhea. Montelukast is an antagonist to the leukotriene receptor. It is non-sedating, dosed once daily, and has a safety profile similar in adults and children, with approval down to six months of age. The purpose of the study was to see the improvement in the severity of symptoms of the patients with allergic rhinitis treated with montelukast.MethodsThe symptom severity score for allergic rhinitis was calculated by asking the patient to evaluate the severity of individual symptoms (sneezing, nasal congestion, rhinorrhea, and postnasal drip) against the 4-point scoring scale over the last 24 hours. After explaining the scoring system to the patient, a proforma was filled before starting the treatment. A dose of 10 mg of montelukast once daily was prescribed. On the follow-up visit after four weeks of therapy, compliance was ensured and then the symptom severity score was recorded again on the proforma. The total nasal symptom severity score (TNSSS) was calculated as a sum of all four nasal symptoms. Pre- and post-treatment mean of TNSSS was compared using a t-test. P-value of less than 0.05 was considered significant.ResultsA total of 140 patients were included in the study. The mean age was 30 years. The minimum age was 15 years and the maximum age was 45 years. There were 93 males and 47 females. The difference between pre- and post-mean values of TNSSS was 5.82. Both pre- and post-mean of TNSSS were compared using the t-test, and P-value was significant, i.e., <0.005.ConclusionsThe common symptoms of allergic rhinitis evaluated in the study showed improvement in response to the treatment with montelukast. The improvement in symptom severity score was maximum in sneezing and least in rhinorrhea. In light of recent developments on neuropsychiatric adverse effects and FDA warnings, caution needs to be exercised to reserve the use of montelukast for the selected patients.

Anti-leukotriene agents in modern therapy of bronchial asthma in children

The article highlights the present-day knowledge on the role of leukotrienes in the pathogenesis of allergic diseases of respiratory tract such as bronchial asthma in children. It presents the mechanisms of action that determine the points of application and recommended indications for use of Montelukast, a leukotriene receptor antagonist. The clinical trials showed its efficacy and safety in children of 2 years and over. Montelukast is used to prevent daytime and night-time symptoms of bronchial asthma, bronchospasm caused by physical exertion and cold air, treat bronchial asthma in patients with hypersensitivity to acetylsalicylic acid, known as aspirin asthma, improve the daytime and night-time symptoms of seasonal and/or year-round allergic rhinitis in children. Montelukast is effective in bronchial asthma caused by viral, specifically rhinovirus, infections, and in bronchial asthma combined with allergic rhinitis. It can be successfully used as monotherapy in mild bronchial asthma. If situation requires to strengthen the baseline therapy in moderate and severe bronchial asthma, the alternative to increasing the dose of inhaled glucocorticosteroids would be addition of Montelukast to the complex therapy. The drug is well tolerated, side effects are quite rare. It must be admitted that today anti-leukotriene agents have filled a specific market niche in the treatment of bronchial asthma and allergic rhinitis in children, have showed their clinical efficacy, especially in certain phenotypes of the disease, which proves that they would become widely used in the near future.

Montelukast use over the past 20 years: monitoring of its effects and safety issues.

Montelukast, a leukotriene receptor antagonist, was launched 20 years ago in Korea. It is recommended as an alternative treatment for asthma in children with mild persistent symptoms or as an add-on treatment to existing low-dose inhaled corticosteroids (ICSs) in children who require additional treatment. However, in the real-world setting, many doctors and patients prefer montelukast over ICSs despite their lower efficacy. Although montelukast is considered to be a safe drug, there are concerns regarding adverse drug reactions, including the rare occurrence of Churg-Strauss syndrome and, despite insufficient data, the possibility of neuropsychiatric events such as anxiety, depression, sleep disturbance, and suicidality. This review identified that montelukast has significantly contributed to asthma control over the past 20 years in Korea and has been critical for reducing asthma severity, especially early wheezing and disease control. Our findings suggest that the effects of montelukast treatment can be monitored by measuring serum eosinophilderived neurotoxin levels.

Does short-term montelukast treatment cause sleep problems or psychiatric problems in children? A preliminary study

Aim: Montelukast is one of the treatment choices for symptomatic allergic rhinitis and asthma in children. Various researches emphasized that montelukast use causes neuropsychiatric side effects. The aim of this study was to investigate the effect of short-term montelukast use on children's sleep habits, and whether sleep-related problems and psychiatric problems may occur. Material and Methods: This prospective study was conducted with 30 children. Psychiatric disorders and symptoms, sleep habits, sleep-related problems were evaluated before the use of montelukast. All of these evaluations were repeated at 4th and 8th week of treatment. Psychiatric assessment was performed with the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version – Turkish. Sleep habits, sleep-related problems were assessed using the Children Sleep Habits Questionnaire Short Form (CSHQ-S) and the Pediatric Sleep Questionnaire (PSQ). Results: According to the psychiatric assessment, no psychiatric disease or symptom was identified before treatment and at the 4th and 8th week of treatment. The CSHQ-S and PSQ responses were evaluated and there was no significant difference between results obtained before treatment and at the 4th and 8th weeks of treatment. Conclusion: The results revealed that short-term montelukast use is safe and do not cause changes sleep habits, sleep-related problems or psychiatric problems in children. Long-term follow-up studies with high numbers of participants are needed to test these results and evaluate the possible neuropsychiatric side effects of long-term montelukast use.

Anti-leukotriene drugs in modern pediatric practice

The article summarizes the modern data on the role of leukotrienes in the pathogenesis of allergic diseases of the respiratory tract, in particular, bronchial asthma in children. It determines the role of anti-leukotriene drugs in the treatment of these diseases, the perspectives and key indications for the use of Montelukast in children with bronchial asthma and allergic rhinitis. The article pays attention to highly effective generics, in particular Singlon®.

Prevalence of Montelukast Use as an Add-On Therapy among Iraqi Asthmatics on Treatment Attending Al-Kindy Teaching Hospital and Al-Zahraa Center of Asthma and Allergy.

BACKGROUND:Montelukast (Singulair) is a cysteinyl leukotriene receptor antagonist, used for the maintenance treatment of asthma and to relieve symptoms of seasonal allergic rhinitis and asthma, also used for exercise-induced bronchospasm.AIM:This study was performed to determine the prevalence of Montelukast use as an add-on therapy among Iraqi asthmatic patients on treatment. Comparing the effectiveness of regimens with and without montelukast.METHODS:This descriptive cross-sectional study was carried out on 73 Iraqi asthmatic patients on treatment of both sexes with age range (18-60) years old, attending Al-Kindy Teaching Hospital and Al-Zahraa Centre of Asthma and Allergy, Baghdad, for the period between February and March 2017. A questionnaire was specifically prepared to meet the objectives and was used to collect the data of the study.RESULTS:There was a significant statistical reduction of frequency in asthmatic attacks after Montelukast treatment (p-value < 0.05). Out of 73 patients, 39 were males, and 34 were females, 46 were jobless, 37 were married, 63 were urban residents, 63 were educated. Prevalence of exacerbation factors was as following: infection was found in 60.3% of the patients, exercise in 57.5%, dust in 72.6%, smoking in 60.6%, food in 24.7%, others (stress, perfumes) in 20.5%. The prevalence of Montelukast use in this study was 46% (34 patients). Out of 34 patients using Montelukast, 28 were using inhaled salbutamol, 5 were using oral salbutamol, 15 were using inhaled corticosteroids, 9 were using systematic corticosteroids, 2 were using xanthines, and 6 were using ketotifen.CONCLUSION:Montelukast was used as add-on therapy with the inhaled corticosteroids to reduce the required dose of inhaled corticosteroids also the use of Montelukast lead to reduced number of exacerbations which will be reflected on the use of inhaled salbutamol and systematic corticosteroids. Also, Montelukast was superior to xanthines and ketotifen as an add-on therapy.

The Impact of Bronchial Thermoplasty on Asthma-Related Quality of Life and Controller Medication Use

Background: Despite an improved understanding of the pathophysiology of asthma, severe asthma sufferers continue to experience a poor quality of life (QOL). Bronchial thermoplasty (BT) utilizes thermal energy to reduce airway smooth muscle. In industry-sponsored trials, BT improves QOL and reduces severe exacerbations; however, the impact of BT on asthma-related QOL and medication use in non-industry-sponsored trials is less clear. Objective: The aim of this study was to determine the impact of BT on asthma QOL measures (mini-AQLQ) and asthma controller medication use during the year following treatment with BT. Methods: We performed a prospective study of the impact of BT in 25 patients with severe persistent asthma. Our primary outcome was change in asthma-related QOL score (mini-AQLQ) 1 year after BT treatment. Our secondary outcome was change in asthma medication use 1 year after BT. Results: BT led to an improvement in mini-AQLQ score from a baseline of 3.6 ± 0.3 before therapy to 5.6 ± 0.3 1 year after the final BT procedure. Overall, 88% percent of patients showed a clinically significant improvement in mini-AQLQ at 1 year. Patients treated with BT showed a reduction in the use of montelukast and omalizumab 1 year after BT. Conclusion: In patients with severe persistent asthma and low asthma-related QOL scores, BT leads to an improvement in asthma-related QOL and a decrease in asthma medication use when measured 1 year after the final BT treatment.

Leukotriene receptor antagonists for eczema.

Leukotriene receptor antagonists for eczema.

Abstract 9.00 EFFECT OF MONTELUKAST ON CAPSULAR CONTRACTURE AFTER BREAST AUGMENTATION: A COMPARATIVE STUDY

BACKGROUND: Leukotriene antagonists zafirlukast and montelukast have been used by plastic surgeons off-label to prevent and treat capsular contracture in breast implant surgery. At the present, only few studies investigated their efficacy. METHODS: A retrospective analysis was performed to investigate the effectiveness of montelukast in preventing and treating capsular contracture. This study included 177 consecutive women who underwent cosmetic breast surgery using textured silicone prostheses. Same surgeon operated all women using infra-mammary approach and dual-plane pocket and a treatment of at least 3 months of montelukast was offered to them at the regimen of 20mg once a day. Therefore, patients were divided into two groups on the basis of montelukast treatment. Follow-up on montelukast efficacy was obtained by a combination of office chart review and strandardized telephone questionnaire with a minimum follow-up of 4 years. RESULTS: Sixty-seven patients received montelukast for 3–6 months. Mean age of the patients was 35.82 ± 8.71 years (range 19–56 years), and co-morbidity was present in 11.76% of cases. All groups combined had a mean follow-up evaluation of 58.71 ± 13.45 months (range 48–136 months) and mean breast size (cc) of 333.89 ± 107.60 cc (range 155–690 cc). No significant differences were found for the use of montelukast versus control in the prevention of capsular contracture after surgery, although the number of affected patients and the severity of capsular contracture were higher among the patients who did not use montelukast. No adverse effects were found. CONCLUSIONS: Montelukast may prevent and improve symptoms of capsular contracture. However, further studies are needed for justifying its somministration.

A systematic review on the off-label use of montelukast in atopic dermatitis treatment.

Background Atopic dermatitis (AD) is the most common form of eczema. As leukotriene mediators are involved in the inflammatory phase of atopic dermatitis, montelukast has been suggested as a possible therapy. Aim of the review To evaluate the safety and efficacy of montelukast off-label usefor thetreatmentatopic dermatitis. Method A search was performed from database inception until March 2018 in six electronic databases for randomized-controlled-trials examining the use of montelukast for AD. Results Among 301 articles screened, 11 studies met the inclusion criteria and were included in the review. The study populations consist of paediatric and adult subjects with moderate-to-severe AD. Montelukast use was shown to improve symptoms such as pruritus in four studies. Another 2 studies reported that montelukast could improve symptoms similar to the standard regimen of topicalsteroid and oralantihistamine. However, five studies reported that montelukast had no effects in symptoms alleviation. The use of montelukast was associated with a similar safety profile to placebo and well-tolerated with minimal adverse effects. Conclusion There is limited evidence to suggest that the off-label use of montelukast is effective in treating moderate-to-severe AD. Further research with larger study populations employing standardized endpoint measuring instrument is warranted to further investigate the off-label use of montelukast in AD treatment. Until then, the use of conventional treatments including optimal daily skin hydration should remain the mainstay in themanagementof atopic dermatitis. In fact, for moderate-to-severe condition, steroid sparing immune-suppressants should still be used clinically until more effective and safer alternative is discovered.

Early Discontinuation of Montelukast Treatment; A Danish Nationwide Utilization Study

Montelukast, a leukotriene receptor antagonist, was marketed in 1998 as an oral supplementary treatment to patients with mild to moderate asthma. The aim of this study was to describe the early discontinuation pattern among montelukast users in Denmark in the period of 1 March 1998 to 31 December 2016, and to identify demographic characteristics possibly associated with early discontinuation. This nationwide drug utilization study was based on data collected from three nationwide Danish registers. All montelukast users who redeemed at least one prescription in the study period were identified. Early discontinuation was defined as failing to fill a second prescription for montelukast within at least a year after the initial montelukast prescription. Among 135,271 included montelukast users, 47,480 (35%) discontinued the use of montelukast after a single redeemed prescription. The trend in early discontinuation increased throughout the years. The most predominant demographic risk factors for early discontinuation were prescription for only nasal topical anti-allergic treatment up to a year prior to montelukast initiation [adjusted odds ratio (OR) 2.25; 95% confidence interval (CI) 2.13-2.38], as well as suspected off-label use (adjusted OR 2.02; 95% CI 1.97-2.08). Several risk factors were associated with a decreased risk of early discontinuation; most pronounced was a prescription of inhaled corticosteroids within a year up to montelukast initiation [adjusted OR 0.47 (95% CI 0.46-0.49)]. Early discontinuation was more pronounced after patent expiry in 2012 [adjusted OR 1.42 (95% CI 1.38-1.45)]. In conclusion, we found that early montelukast discontinuation increased during the last 19years. Appropriateness of the treatment indication as estimated by concomitant prescription of adequate inhalation therapy was associated with a low risk of early discontinuation. A more pronounced early discontinuation was observed after patent expiry in 2012, which could reflect a more liberal approach to montelukast prescription.

Efficacy of Episodic Use of Montelukast in Preschool Children with Intermittent Wheezing

Efficacy of Episodic Use of Montelukast in Preschool Children with Intermittent Wheezing