Clinical Question:
Is Montelukast (Singulair) effective on asthmatic patients with seasonal
asthma symptoms?
Bottom Line:
In patients with chronic asthma and seasonal aeroallergen sensitivity,
montelukast treatment provided significant asthma control during the allergy
season compared with placebo.
Reference:
Efficacy of montelukast during the allergy season in patients with chronic
asthma and seasonal aeroallergen sensitivity.Busse WW, Casale TB, Dykewicz
MS, Meltzer EO, Bird SR, Hustad CM, Grant E, Zeldin RK, Edelman JM.Ann
Allergy Asthma Immunol. 2006 Jan;96(1):60-8.
Study Design:
Randomized, parallel-group, multicenter study
Synopsis:
Montelukast has proven efficacy in the treatment of chronic asthma and
seasonal allergic rhinitis, but it has not been evaluated in the
subpopulation of asthmatic patients with seasonal asthma symptoms. To
determine the effectiveness of montelukast treatment in improving the
control of asthma symptoms during the allergy season in patients with active
asthma and seasonal aeroallergen sensitivity. Adults with a history of
chronic asthma who are also symptomatic during the allergy season and with
skin test sensitivity to seasonal aeroallergens were enrolled in a
randomized, parallel-group, multicenter study with a 1-week, single-blind,
placebo run-in period followed by 3 weeks of double-blind treatment during
the spring of 2004. After the run-in period, eligible patients were randomly
assigned to receive either oral montelukast (10 mg) or placebo. Daytime and
nighttime asthma symptom scores, beta-agonist use, and morning and evening
peak expiratory flow rates were recorded daily using an electronic diary.
The primary end point was mean change from baseline to week 3 in the daytime
asthma symptom score. Of 455 randomized patients, 433 completed the study.
Compared with placebo, treatment with montelukast resulted in a significant
improvement from baseline in the daytime asthma symptom score (-0.54 vs
-0.34; P = .002) and in beta-agonist use, nighttime symptoms, and peak
expiratory flow rates. Few patients in the montelukast and placebo groups
discontinued study participation because of asthma (1.3% and 3.0%,
respectively). |