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Single-dose desloratadine and montelukast and allergen-induced late airway responses

¹ Dept of Pharmacology, College of Medicine, University of Saskatchewan, and, ² Division of Respirology, Dept of Medicine, Royal University Hospital, University of Saskatchewan, Saskatoon, SK, ³ Dept of Medicine, McMaster University, Hamilton, ON, and ⁴ Institut de cardiologie et de pneumologie de l’Universite Laval, Hôpital Laval, Quebec City, QC, Canada.

CORRESPONDENCE: B. E. Davis, Division of Respiratory Medicine, University of Saskatchewan, 5th Floor Ellis Hall, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada. Fax: 1 3069668694. E-mail: beth.davis{at}usask.ca

Keywords: Antihistamine, antileukotriene, asthma, eosinophil, inflammation, sputum

Received: November 7, 2008
Accepted December 19, 2008

Montelukast and desloratadine synergistically inhibit the allergen-induced early asthmatic response. Montelukast also suppresses the allergen-induced late asthmatic response, but there are no reports on the effect of desloratadine or the combination on the allergen-induced late asthmatic response.

Atopic asthmatics (n = 10) completed a multicentric randomised double-blind crossover study comparing single-dose placebo, 5 mg desloratadine, 10 mg montelukast and the combination administered 2 h prior to allergen inhalation challenge. Methacholine challenges were performed 24 h before and after allergen challenge. Exhaled nitric oxide measurements and sputum inflammatory cell counts were also carried out.

All active treatments significantly decreased the late asthmatic response area under the curve. Combination therapy provided the greatest inhibition compared to desloratadine and montelukast. Montelukast was nonsignificantly better than desloratadine but not as effective as the combination. There was a trend towards a decrease in airway responsiveness following montelukast and combination. Montelukast, but not desloratadine or the combination, decreased exhaled NO levels 24 h after allergen. The allergen-induced increase in sputum eosinophil numbers was significantly suppressed at 7 h with desloratadine and combination therapy, and at 24 h with montelukast and combination therapy.

Single-dose co-administration of desloratadine and montelukast 2 h prior to allergen inhalation clinically abolished the late asthmatic response and eosinophil recruitment.