Oral Montelukast Not Effective as Adjuvant in Pediatric Acute Moderate Asthma

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Children with an acute exacerbation of asthma were randomly assigned to receive a single tablet of montelukast or placebo.

NEW ORLEANS — The addition of oral montelukast to standard therapy may not improve treatment outcomes in children with acute moderate asthma, according to the results of a study presented at the CHEST Annual Meeting 2019, held October 19 to 23 in New Orleans, Louisiana.

In this double-blind placebo-controlled trial, 41 children aged 5 to 12 years presenting to the emergency department or outpatient unit of a medical college in Alleppey, Kerala, India, with acute exacerbation of asthma were randomly assigned to receive a single 5 mg-tablet of montelukast (n=27) or placebo (n=14).

Children were excluded from the study if they met one of the following criteria: inability to take oral medication, administration of montelukast in the week preceding the study, presence of a cardiorespiratory condition or suspected pneumonia, or a lack of parental consent.

Study participants had a Pulmonary Scoring Index (PSI) score between 4 and 6 at presentation, reported ≥3 past coughing/wheezing episodes, and were responsive to bronchodilators. PSI score was assessed at baseline and 4 hours after treatment administration.

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The reduction in PSI scores was comparable between children treated with montelukast vs placebo (3.08±0.781 vs 2.71±0.825, respectively; P =.167), indicating a lack of benefit of montelukast as an adjuvant to standard therapy for acute moderate asthma.


Venugopal S, Mohan G, Cherungonath A. Effect of addition of single dose of oral montelukast to standard therapy in acute moderate asthma in children 5 to 12 years of age: a randomized double-blind placebo controlled trial. Presented at: CHEST Annual Meeting 2019; October 19-23, 2019; New Orleans, LA. Abstract 1603.