By Nikhil, Journals Correspondent, [RxPG] Montelukast, a leukotriene receptor antagonist, significantly decreased the rate of exacerbations and lengthened the time between exacerbations in 2- to 5-year-old asthma patients who suffered from intermittent symptoms. The researchers pointed out that montelukast significantly reduced by almost 32 percent the rate of exacerbations over 12 months, as compared with results from patients on placebo. The average rate of exacerbation episodes was 1.60 episodes per patient per year, compared with 2.34 for placebo. (Leukotrienes are biologically active compounds that function as chemical mediators. They have vasoactive properties that help regulate allergic and inflammatory reactions. Medical antagonists are designed to counteract specific functions.) According to the authors, asthma usually begins and has its greatest prevalence in children younger than 5 years.
This age group often has intermittent symptoms, which include long assymptomatic periods interrupted by episodes of asthma generally in association with the common cold. Viral infections, predominately with rhinovirus, account for up to 85 percent of childhood asthma exacerbations and daily symptoms. The investigators claim that there are usually minimal symptoms between episodes. The 1-year study directed at exacerbation control was conducted at 68 sites in 23 countries. It involved 278 children receiving low-dose montelukast once a day for 12 months, along with 271 young participants receiving placebo. According to the authors, montelukast delayed the median time to first exacerbation by approximately 2 months. It also significantly reduced the overall rate of corticosteroid use by almost 32 percent and the rate of inhaled corticosteroid use by almost 40 percent. However, although the use of montelukast reduced exacerbations in intermittent asthma, the investigators said that they do not necessarily advocate year-round regular treatment with the compound. They noted that since exacerbations tended to be seasonal, therapy should begin before the viral season when the exacerbation rate is high.