Inhaled corticosteroids or montelukast as the preferred primary long-term treatment for pediatric asthma?

European Journal of Pediatrics
Tuomas Jartti

Abstract

According to current guidelines, inhaled corticosteroids (ICS) are the preferred primary long-term treatment for asthmatic children of all age groups, but leukotriene receptor antagonists can be considered to be an alternative treatment for mild persistent asthma. In this article, all randomized double-blind efficacy studies comparing the long-term (>4-week) treatment using a leukotriene receptor antagonist with an inhaled corticosteroid in asthmatic children were critically reviewed. In school-aged children, five reports with an adequate study design were available. All of these studies compared montelukast with inhaled fluticasone. The meta-analysis of the two main outcome measures, forced expiratory volume in 1 s (weighted mean difference, 4.6% predicted, 95% confidence interval: 3.5-5.5) and asthma control days (respectively, 5.6%, 4.3-6.9) demonstrated the superiority of fluticasone over montelukast. Many other clinical and pulmonary outcomes also consistently showed that low-dose inhaled fluticasone was more effective than montelukast in the long-term management of mild to moderate persistent asthma. A more favorable response to fluticasone over montelukast was associated with more severe disease or markers of allergic in...Continue Reading

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Citations

Jun 30, 2009·Advances in Therapy·Jean BousquetMarc Humbert
Sep 11, 2012·Multidisciplinary Respiratory Medicine·Alessandra ScaparrottaFrancesco Chiarelli
Aug 18, 2012·Paediatric Drugs·Catalina DumitruVictor Turcanu
Oct 24, 2013·BioMed Research International·Nathália Brandão GobbatoEdna Aparecida Leick
Jun 17, 2014·Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology·Denis BérubéAllan Becker
Dec 17, 2009·Current Medical Research and Opinion·Stefan ZielenJohannes Schulze
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Nov 2, 2013·Clinical Reviews in Allergy & Immunology·T E AlbertsonS Louie
Sep 24, 2014·Clinical Pediatrics·Marta KrawiecMarek Kulus

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