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Leukotriene receptor antagonists: efficacy and safety in children with asthma
1Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada. becker@cc.umanitoba.ca
Insights
Montelukast significantly improved lung function and quality of life in children with asthma. This leukotriene receptor antagonist demonstrated safety and efficacy in pediatric asthma management.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Clinical Trials
Background:
- Limited research exists on chronic leukotriene receptor antagonist use in children.
- Asthma significantly impacts children's quality of life and respiratory health.
Purpose of the Study:
- To evaluate the efficacy and safety of montelukast in children aged 6-14 with asthma.
- To assess the long-term effects of montelukast on lung function and quality of life.
Main Methods:
- An 8-week, double-blind, placebo-controlled trial involving 336 children with asthma.
- A 6-month open-label follow-up study.
- Assessment of forced expired volume in 1 second (FEV(1)), beta-agonist use, asthma exacerbations, and quality of life.
Main Results:
- Montelukast significantly improved FEV(1) compared to placebo (8.23% vs. 3.58%).
- Reduced beta-agonist use, asthma exacerbations, and improved quality of life were observed.
- Long-term FEV(1) improvements were sustained, comparable to beclomethasone treatment.
Conclusions:
- Montelukast is effective and safe for treating pediatric asthma.
- Leukotriene receptor antagonists offer significant benefits for children with asthma.
- Montelukast improves lung function, reduces exacerbations, and enhances quality of life in pediatric patients.
Abstract:
To date, only one study of chronic use of a leukotriene receptor antagonist in children has been published. The efficacy and safety of montelukast in children 6-14 years of age with asthma (n = 336) was studied during an 8-week, double-blind, placebo-controlled trial. There was significantly greater improvement in forced expired volume in 1 sec (FEV(1)) from baseline for the montelukast group (8. 23%) compared to the placebo group (3.58%). There was a significant decrease in use of beta agonists for symptom relief and a significant decrease in the percentage of days and percentage of patients with asthma exacerbations. An asthma-specific quality of life questionnaire revealed significant overall improvement in quality of life and significant improvement in the quality of life domains for symptoms, activity, and emotions. Adverse effects were not significantly different for montelukast than for placebo, with the exception of allergic rhinitis which was more prevalent in the placebo group. A 6-month open follow-up of patients from the above study was undertaken. Effects of montelukast on FEV(1) were consistent over the 6 months, with the increase in FEV(1) not significantly different from a small control group treated with beclomethasone. Quality of life remained significantly improved throughout the open treatment period. In conclusion, leukotriene receptor antagonists are of value for the treatment of children with asthma.