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Published ahead of print on October 3, 2002, doi:10.1164/rccm.200207-747OC
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American Journal of Respiratory and Critical Care Medicine Vol 167. pp. 379-383, (2003)
© 2003 American Thoracic Society

Original Article

A Randomized Trial of Montelukast in Respiratory Syncytial Virus Postbronchiolitis

Hans Bisgaard for the Study Group on Montelukast and Respiratory Syncytial Virus

Copenhagen Studies on Asthma in Childhood (COPSAC), Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

Correspondence and requests for reprints should be addressed to Hans Bisgaard, M.D., D.M.Sci., Professor of Pediatrics, Copenhagen Studies on Asthma in Childhood (COPSAC), Copenhagen University Hospital, Rigshospitalet, DK-2100 Copenhagen, Denmark. E-mail: Bisgaard{at}copsac.dk

Infants often develop reactive airway disease after respiratory syncytial virus (RSV) bronchiolitis. Cysteinyl-leukotrienes (cys-LT) are released during RSV infection and may contribute to the inflammation. We hypothesized that a cys-LT receptor antagonist would ameliorate reactive airway disease subsequent to RSV bronchiolitis. One hundred and thirty infants who were 3 to 36 months old, hospitalized with acute RSV bronchiolitis, were randomized into a double-blind, parallel comparison of 5-mg montelukast chewable tablets or matching placebo given for 28 days starting within 7 days of symptom debut. Infants with a suspected history of asthma were excluded. One hundred sixteen infants provided diary card data for the treatment period. Median age was 9 months. Infants on montelukast were free of any symptoms on 22% of the days and nights compared with 4% of the days and nights in infants on placebo (p = 0.015). Daytime cough was significantly reduced on active treatment (p = 0.04). Exacerbations were significantly delayed from montelukast compared with placebo (p < 0.05). In conclusion, cys-LT antagonist treatment reduces lung symptoms subsequent to RSV bronchiolitis.

Key Words: respiratory syncytial virus • bronchiolitis • bronchial hyperresponsiveness • infant • leukotriene receptor antagonist




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