Effect of a leukotriene receptor antagonist on the prevention of recurrent asthma attacks after an emergency room visit
Article first published online: 28 JUN 2008
Volume 53, Issue 4, pages 341–347, December 2004
How to Cite
Matsunaga, K., Nishimoto, T., Hirano, T., Nakanishi, M., Yamagata, T., Minakata, Y., Kuroda, M., Ikeda, T., Nakanishi, H. and Ichinose, M. (2004), Effect of a leukotriene receptor antagonist on the prevention of recurrent asthma attacks after an emergency room visit. Allergology International, 53: 341–347. doi: 10.1111/j.1440-1592.2004.00359.x
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Received 28 December 2003. Accepted for publication 21 May 2004.
- β2-adrenergic receptor agonist;
- asthma exacerbation;
- leukotriene receptor antagonist;
Background: The efficacy of montelukast, a specific cysteinyl leukotriene receptor antagonist, in preventing recurrent asthma attacks was evaluated for post-emergency management of acute asthma exacerbation.
Methods: Twenty-two patients with a history of chronic asthma whose symptoms were responsive to an inhaled β-adrenergic receptor agonist in an emergency room setting, were randomized into two groups, those with and those without montelukast (n = 11 for each group). Patients in the montelukast group received an oral dose of 10 mg montelukast before leaving the emergency room following rescue treatment with an inhaled β-adrenergic receptor agonist. Patients in both groups were instructed to use an inhaled β-adrenergic receptor agonist for shortness of breath or dyspnea in post-emergency management. Additional β-adrenergic receptor agonist use, subjective asthma symptoms, sleep impairment, additional emergency visits and/or hospitalization were monitored for 24 hours following the emergency room visit.
Results: In the montelukast group, the need for a rescue β-adrenergic receptor agonist was significantly decreased; 54.5% of patients in the montelukast group required use of β-adrenergic receptor agonist compared with 100% in the non-montelukast group (P < 0.05). The average number of uses of a β-adrenergic receptor agonist was 2.67 ± 3.58 times/24 h in the montelukast group compared with 11.95 ± 3.60 times/24 h in the non-montelukast group (P < 0.01). The average subjective asthma symptom scores were significantly decreased in the montelukast group, whereas no score change occurred in the non-montelukast group. The sleep impairment score was significantly lower in the montelukast group compared with that in the non-montelukast group (P < 0.05). No patients in either group had an emergency visit or hospitalization during this period.
Conclusions: The results demonstrate that montelukast can prevent recurrent asthma exacerbations in the home environment.