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[Montelukast-free interval before inhalational bronchial allergen provocation]
F-W Riffelmann1, G Droste, H Lauter
1Fachkrankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmung und Schlafmedizin, Allergologie, Schmallenberg. f.riffelmann@fkkg.de
Background:
Leukotrienes are potent bronchoconstrictive and proinflammatory mediators in bronchial asthma. In a previous study on 16 subjects with bronchial asthma (two randomized groups) we showed that montelukast (10 mg daily) significantly suppressed allergen provocation with specific allergens (mites and pollen) (p = 0.0005). In a follow-up study we addressed the question as to when montelukast should be discontinued in order to avoid a relevant effect on inhalational bronchial allergen provocation.
Method:
At the end of the first study montelukast (10 mg daily) was given again to both groups (2 x 8 asthma patients) for 21 days. After a montelukast-free period of one and three days allergen provocation was repeated in the same manner and the results were compared with the historic baseline values without montelukast.
Results:
The provocation dose for allergens was reduced by 39% after a montelukast-free period of one day and by 67% after three days. Only after three days was the difference significant (p = 0.017), at which time the control value was nearly reached again.
Conclusion:
We recommend that montelukast be discontinued at least three days prior to inhalational allergen provocation.