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Published ahead of print on October 3, 2002, doi:10.1164/rccm.200207-747OC

Am. J. Respir. Crit. Care Med., Volume 167, Number 3, February 2003, 379-383

A more recent version of this article appeared on February 1, 2003
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Submitted on July 25, 2002
Accepted on October 2, 2002

A RANDOMISED TRIAL OF MONTELUKAST IN RESPIRATORY SYNCYTIAL VIRUS POST-BRONCHIOLITIS

Hans Bisgaard1*

1 Pediatrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

* To whom correspondence should be addressed. E-mail: bisgaard{at}copsac.dk.

Infants often develop reactive airway disease (RAD) 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 RAD subsequent to RSV bronchiolitis. One hundred and thirty infants of 3-36 months, 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 up to 7 days after symptom debut. Children with a suspected history of asthma were excluded. One hundred and 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 to 4% of the days and nights in children on placebo (p=0.015). Day-time 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: bronchial hyperresponsiveness, infant, leukotriene receptor antagonist, respiratory syncytial virus




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