Fluticasone or montelukast in preschool wheeze: a randomized controlled trial

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Marta Krawiec1, Agnieszka Strzelak2, Katarzyna Krenke2

  • 1The Medical University of Warsaw, Warsaw, Poland marta.krawiec@wum.edu.pl.

Clinical Pediatrics
|September 24, 2014
PubMed

Insights

Neither montelukast nor fluticasone effectively prevented preschool wheeze episodes (PWEs). However, fluticasone may reduce PWEs in children exposed to tobacco smoke, warranting further research.

Area of Science:

  • Pediatric Pulmonology
  • Allergy and Immunology
  • Pharmacology

Background:

  • Preschool wheeze episodes (PWEs) affect up to 30% of young children.
  • The efficacy of common antiasthmatic medications for PWEs is not well-established.
  • This study investigated anti-inflammatory treatments for PWEs.

Purpose of the Study:

  • To evaluate the effectiveness of montelukast and fluticasone in preventing recurrent preschool wheeze episodes.
  • To assess the impact of these treatments on PWE frequency, severity, and hospitalizations.
  • To explore potential benefits in specific subgroups, such as those with tobacco smoke exposure.

Main Methods:

  • Randomized controlled trial involving children aged 6-36 months with 1-3 PWEs.
  • Participants were assigned to receive montelukast, fluticasone, or no treatment for 12 weeks.
  • Outcomes included PWE frequency, hospitalizations, and symptom severity.

Main Results:

  • No significant differences in PWE frequency, hospitalizations, or symptom severity were observed between montelukast, fluticasone, and control groups.
  • A notable finding was a significant reduction in PWEs among tobacco-exposed children treated with fluticasone (P = .01).

Conclusions:

  • Montelukast and fluticasone did not demonstrate efficacy in preventing recurrent preschool wheeze episodes in the general study population.
  • Fluticasone may offer a potential benefit for PWE prevention in children with parental tobacco smoke exposure.
  • Larger studies are recommended to confirm the observed effect of fluticasone in this specific subgroup.
Abstract

Keywords:
childrenfluticasonemanagementmontelukastpreschool wheezetobacco exposure

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