Montelukast as add-on therapy to beta-agonists and late airway response

¹ Dept of Paediatrics, Frankfurt University, Theodor-Stern-Kai 7, Germany

^* To whom correspondence should be addressed. E-mail: Martin.Rosewich{at}kgu.de.

	Abstract

We investigated whether single-dose oral LTRA as add-on therapy to short acting beta agonists immediately after allergen challenge blocks the late phase airway response.

35 mild asthmatics (19 male, mean age 24 years) sensitized for house dust mites underwent two courses of bronchial allergen challenge. After the early allergic response (EAR), subjects received salbutamol once and were randomly assigned to either 10 mg of montelukast or placebo (double-blind, crossover). To identify a late allergic response (LAR), FEV₁ was monitored over the following eight hours. Baseline exhaled NO was determined ahead of each allergen challenge.

Baseline NO-levels differed significantly depending on the reaction to allergen challenge. Twelve subjects showed no significant response, 11 an EAR only, and 12 had a dual response and underwent further analysis. The area under the FEV₁ time-response curve 3-8 hours after bronchial allergen challenge was -0.77 (+1.68) from the pre-challenge values on montelukast compared to -2.47 (+1.32) on placebo (p<0.05). Baseline FeNO of subjects without an EAR was significantly (p<0.05) lower than of those presenting a dual response.

Our results demonstrate that single-dose LTRA given orally right after the EAR can significantly inhibit the LAR after bronchial allergen challenge.