ERS: Montelukast May Not Assist Young Children With Wheeze

Intermittent administration beneficial for children in the 5/5 ALOX5 promoter genotype stratum

TUESDAY, Sept. 9, 2014 (HealthDay News) -- For children with wheeze, intermittent montelukast is not associated with clear benefit, according to a study published online Sept. 9 in The Lancet Respiratory Medicine to coincide with the European Respiratory Society's International Congress, held Sept. 6 to 10 in Munich.

Chinedu Nwokoro, M.B.B.Chir., from Queen Mary University of London, and colleagues conducted a randomized multicenter trial involving children, aged 10 months to 5 years, with two or more wheeze episodes. Participants were allocated to a 5/5 or 5/x+x/x ALOX5 promoter genotype stratum and were then randomized to receive intermittent montelukast (669 children) or placebo (677 children) at each wheeze episode. Primary outcome data were available for 1,308 children.

The researchers found that there was no between-group difference in unscheduled medical attendances for wheezing episodes (mean, 2 in montelukast versus 2.3 in placebo group; incidence rate ratio [IRR], 0.88; 95 percent confidence interval [CI], 0.77 to 1.01; P = 0.06). Children given montelukast in the 5/5 stratum had a reduction in unscheduled medical attendances for wheezing episodes (2 versus 2.4; IRR, 0.8; 95 percent CI, 0.68 to 0.95; P = 0.01), but there was no reduction seen for those in the 5/x+x/x stratum (2 versus 2; IRR, 1.03; 95 percent CI, 0.83 to 1.29; P = 0.79).

"Our findings show no clear benefit of intermittent montelukast in young children with wheeze," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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