Montelukast in children with mild persistent asthma

Montelukast is a competitive antagonist of the leukotriene receptors indicated in the treatment of asthma. The aim of the study was to evaluate the lung function changes relative to the addition of montelukast to chronically inhaled corticosteroids in children with mild persistent asthma. In the period May-August 1999 thirty-two 6-13 year old (median 11) children with significant FEV1 reversibility to salbutamol within the previous 6 months (range 12-35%, median 19%) receiving 50-200 mg fluticasone for the previous 6 months, were given montelukast 5 mg daily for 10 weeks. Maintenance of disease control was monitored by clinical and lung function criteria and fluticasone dosage was tapered accordingly. One child was lost to follow-up. By the end of the study fluticasone could be discontinued in 12 patients, halved in 6, maintained in 11 and increased in 2. At the 10- week visit the average PEF was 105±15% of the predicted value (initial 85±10%; t-test: p<0,0001). The average fluticasone dosage was decreased by 49% and slabutamol use by 74% relative to the beginning of the study (t-test: p<0,0001). There were no clinically relevant side-effects. Parents generally rated the introduction of montelukast as an improvement in their perception of asthma control.