Randomized placebo-controlled trial comparing montelukast and cetirizine for treating perennial allergic rhinitis in children aged 2–6 yr

Leukotriene receptor antagonists (LTRAs) were recently added to the method of treating allergic rhinitis (AR). However, in children under 6 yr old, there has been no study about its efficacy in treating AR. We aim to compare the clinical efficacy of montelukast, cetirizine and placebo in the treatment of children from 2 to 6 yr old with perennial allergic rhinitis (PAR), to see if there are any significant differences. Sixty children were selected and treated with montelukast, or cetirizine, or placebo once daily. The efficacy of the three agents was compared with the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and Total Symptom Score (TSS) by diary. In addition, we also examined serum IgE, serum eosinophil cationic protein (ECP), blood eosinophil counts, nasal airway resistance (NAR) and eosinophil percentage in nasal smears. The results revealed that both montelukast and cetirizine were significantly efficacious compared with placebo in NAR, eosinophil percentage in nasal smears, PRQLQ, TSS and all symptom items except nasal itching, throat itching and tearing. For nasal itching, only cetirizine was significantly efficacious. On the other hand, for night sleep quality, montelukast was significantly superior to cetirizine.     

孟鲁司特钠对大鼠异丙肾上腺素心肌坏死的保护作用

 目的观察白三烯受体拮抗剂孟鲁司特钠对大鼠心肌坏死的保护作用。方法大鼠皮下注射异丙肾上腺素(2 mg·kg^-1)造成心肌坏死模型，ig给予孟鲁司特钠，测定血清AST，LDH，CK，MDA含量，心肌NO含量和坏死心肌面积。结果大鼠预先给予孟鲁司特钠10.0，30.0 mg·kg^-1，可以降低血清LDH，CK，MDA含量，减少心肌坏死面积。孟鲁司特钠30.0 mg·kg^-1还能促进心肌NO释放。结论孟鲁司特钠对大鼠异丙肾上腺素心肌坏死具有保护作用，有进一步研制成心肌缺血治疗药物的可能。     

孟鲁司特治疗42例儿童轻度哮喘临床疗效

目的:观察孟鲁司特治疗儿童轻度哮喘的疗效。方法: 42例轻度哮喘病儿,男性26例,女性16例,年龄(8. 4±s1. 2)a, 6 ~12a。均口服孟鲁司特,每晚5mg,共3mo,观察哮喘症状评分变化及肾上腺素β2 受体(β2 受体)激动剂使用次数。结果:日间症状评分,夜间症状评分,咳嗽评分治疗前分别为(0. 56±0. 14)分, (0. 46±0. 12)分, (1. 12±0. 24)分。治疗后分别为(0. 09±0. 03)分, (0. 06±0. 02)分, (0. 24±0. 04)分(P<0. 01)。使用β2 受体激动剂次数治疗前为每日( 1. 0±0. 4 )喷,治疗1~3mo后降至每日( 0. 12±0. 03 )喷(P<0. 01 )。临床总有效率达91 % ( 38 /42 )。无头痛、心悸、恶心、腹泻,皮疹等不良反应。结论:孟鲁司特治疗儿童轻度哮喘效果满意,依从性好。     

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??Abstract??Wheeze is a common symptom in infants and pre-school children characterized by chronic inflammation of the airway. The management of infantile wheeze focuses on anti-inflammatory agents including corticosteroids?? bronchodilators?? leukotriene receptor antagonists?? antihistamine drugs and macrolides. Here we reviewed the current medications of infantile wheeze and propose a de-escalation combined therapy based on our long-term practice.     

Montelukast in the treatment of asthma as a systemic disease

Asthma affects 300 million people worldwide. The common association of asthma with allergic rhinitis and the presence of proinflammatory mediators in the circulation of patients provide strong evidence for the need to treat asthma as a systemic disease. The leukotriene receptor antagonist montelukast is a disease-specific oral medication that has dual effects on airway smooth muscle cells and inflammatory processes. This review describes recent randomized, controlled studies of montelukast in asthma and allergic rhinitis in adults and children as young as 3 months old. Montelukast treatment consistently produced significant reductions in asthma exacerbations. While many patients may benefit from montelukast as monotheray, combination treatment for chronic asthma with inhaled corticosteroids is advocated as being rational. Significant improvements in symptoms and quality of life were observed in allergic rhinitis patients. Montelukast is well tolerated in patients of all ages. Long-term studies are underway to determine its effects on airway remodeling.     

Protection of montelukast on OVA-induced eosinophilic gastroenteritis via modulating IL-5, eotaxin-1 and MBP expression

Abstract

The aim of this study was to further explore the possible mechanisms of montelukast on oral mice ovalbumin-induced eosinophilic gastroenteritis in a mouse model. The results indicated that montelukast could prevent levels of eotaxin-1 and interleukin-5 in intestinal mucosa homogenate when compared with model group. Interestingly, the increase of major basic protein expression in jejunal tissue also was attenuated by treated with montelukast.     

Efficacy and safety of montelukast for pediatric obstructive sleep apnea syndrome: A protocol for systematic review and meta-analysis

Background:Pediatric obstructive sleep apnea syndrome (OSAS) is significant public concern. Clinical practice indicates that montelukast has certain therapeutic advantages, while there is a lack of evidence-based medicine support. The aim of this study is to synthesize related data to explore efficacy and safety of montelukast for pediatric OSAS.Methods:Data in Pubmed, EMBASE, CENTRAL, CBM, CNKI, WanFang, VIP databases were comprehensively searched. All the randomized controlled trials (RCTs) in OSAS children were identified, in which the effects of montelukast on a range of outcomes were compared. The search had a deadline of January 1, 2020. Two investigators independently conducted data extraction and assessed the literature quality of the included studies. The Revman5.3 software was used for meta-analysis of the included literature.Results:The efficacy and safety of montelukast in the treatment of pediatric OSAS were evaluated in terms of apnea hypopnea index (AHI), the Pittsburgh Sleep Quality Index, the Epworth Sleep Scale (ESS), neck circumference, important index in Polysomnography: sleep efficiency, desaturation index, total sleep time.Conclusions:This study provides reliable evidence-based support for the clinical application of montelukast in the treatment of pediatric OSAS.PROSPERO registration number:CRD42020146940.     

A Randomized,Multicenter, Double-blind,Phase III Study to Evaluate the Efficacy on Allergic Rhinitis and Safety of a Combination Therapy of Montelukast and Levocetirizine in Patients With Asthma and Allergic Rhinitis

Purpose

The aim of this study was to evaluate the efficacy and safety of a fixed-dose combination of montelukast and levocetirizine in patients with perennial allergic rhinitis with mild to moderate asthma compared with the efficacy and safety of montelukast alone.