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The Effect of Montelukast on Exhaled Nitric Oxide and Lung Function in Asthmatic Children 2 to 5 Years Old^*

^* From the University Children’s Hospital Zürich (Drs. Straub, Minocchieri, Moeller, and Wildhaber), Swiss Paediatric Respiratory Research Group, Zürich, Switzerland; and University of Homburg (Dr. Hamacher), Homburg, Germany.

Correspondence to: Daniel A. Straub, MD, Division of Respiratory Medicine, University Children’s Hospital, Steinwiesstrasse 75, CH-8032 Zürich, Switzerland; e-mail: daniel.straub{at}kispi.unizh.ch

Objective: The study was undertaken to investigate the influence of once-daily treatment with montelukast (Singulair; MSD; Glattbrugg, Switzerland) on levels of exhaled nitric oxide (eNO) and lung function in preschool children with asthma.

Methods: A total of 30 children (19 girls), 2 to 5 years of age, in whom asthma had been newly diagnosed, who had a positive first-degree family history of asthma and a positive allergy test result, were allocated to undergo a 1-week run-in period of montelukast treatment. eNO and airway resistance were measured in all patients before (visit 1) and after the run-in period (visit 2), and after treatment with montelukast (4 mg once daily) for 4 weeks (visit 3).

Results: There were no significant differences in all parameters before and after the run-in period. However, the mean (SD) levels of eNO and the mean (SD) levels of airway resistance after treatment at visit 3 were 11.6 parts per billion (ppb) [9.5 ppb] and 1.15 kPa/L/s (0.26 kPa/L/s), respectively, and were significantly lower compared to values of 33.1 ppb (12.0 ppb) and 1.28 kPa/L/s (0.23 kPa/L/s), respectively, before treatment (p < 0.001) and at visit 2 (p = 0.01). There was no significant change in mean bronchodilator responsiveness between visit 3 (13.2%; SD, 6.8%) and visit 1/visit 2 (13.3%; SD, 7.0%; p = 0.47).

Conclusion: We have shown that montelukast has a positive effect on lung function and airway inflammation as measured by nitric oxide level in preschool children with allergic asthma.

Key Words: airway resistance • asthma • bronchodilator responsiveness • inflammation • lung function test • montelukast • nitric oxide • preschool children

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				P. Montuschi, C. Mondino, P. Koch, G. Ciabattoni, P. J. Barnes, and G. Baviera Effects of Montelukast Treatment and Withdrawal on Fractional Exhaled Nitric Oxide and Lung Function in Children With Asthma Chest, December 1, 2007; 132(6): 1876 - 1881. [Abstract] [Full Text] [PDF]