Montelukast Improves Symptoms and Quality-of-life in Patients with Asthma and/or Allergic Rhinitis
Introduction
Allergic rhinitis (AR) is the most commonly associated comorbidity with asthma. Patients with AR and asthma need lifelong therapies due to symptomatic relapses and often lead to poor patient compliance. Montelukast, a leukotriene antagonist seems to improve the quality-of-life (QoL) by providing significant symptom relief. A single-dose montelukast therapy might be a better and patient friendly alternative.
Aim
This study assessed the improvements in symptoms and QoL as well as safety of montelukast in patients with AR, asthma or both.
Method
Study Design
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Prospective, open-label study
Patient Profile
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Subjects aged >18 years with a clinical diagnosis of AR, asthma or both
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Patients were categorized into intermittent or persistent depending on severity and duration of symptoms
Treatment Strategy
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Details about symptoms, individual assessment of QoL, sleep, work, physical activity were recorded at baseline
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Patients received 10 mg Montelukast tablet daily
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Follow-up visit was scheduled in the 4th week, where the endpoints were evaluated
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General improvements were categorized as very good, good, satisfactory, sufficient or not sufficient
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Specific improvements in symptoms or QoL were categorized as strong, marked, moderate or none
Endpoints
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% patients with improvement in symptoms
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% patients with QoL improvement
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Incidence of adverse events (AEs)
Results
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Baseline characteristics of the total cohort of 694 patients were as follows
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19.8% had AR, 42.4% had asthma, and 39.3% had both
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Mean age was 41.1±4.63 years
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50.7% were males and 49.3% were females
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62.4% had no family history of asthma
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Most had persistent disease
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Almost all the patients showed day and night-time symptoms with cough being the most prevalent
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Significant proportion of patients reported sufficient improvement as seen in Figure 1.
Figure 1. % of patients with sufficient improvement
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Strong or marked improvement in the day (n=342,62.3%) and night-time (n=331,60.3%) asthma symptoms was demonstrated
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About 60% showed very good or good improvements in QoL
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Montelukast was well-tolerated with 18% incidence of AEs
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AEs included abdominal discomfort, fever, fatigue, headache, rash, and upper respiratory tract infection symptoms
Conclusion
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Montelukast 10 mg daily resulted in a significant improvement in the symptoms and quality-of-life in patients with asthma and/or allergic rhinitis
Pak J Med Sci. 2020 Nov-Dec; 36(7): 1517–1522.
