Protective effect of montelukast on both lower and upper respiratory responses to acute cat allergen exposure

• Published in: Journal of allergy and clinical immunology 2004-02, Vol.113 (2), p.S94-S94
• Main Authors: Wood, R.A., Perry, T., Philip, G., Corren, J., Malice, M., Massaad, R., Reiss, T.F.
• Format: Article
• Language: English
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2003.12.326

To study effects of montelukast on lower and upper airway responses to controlled cat allergen challenge in patients with concomitant asthma and allergic rhinitis. This randomized, cross-over study treated patients (n=58) with montelukast 10-mg vs placebo during two 2-week, double-blind treatment periods, separated by a 1-week washout. Following each treatment period, patients underwent ≤60-minute exposure to naturally-generated airborne cat allergen. Lower and upper airway reactions were measured by spirometry and symptom scores. Montelukast demonstrated protection (p≤0.001) against allergen challenge in the lower airway endpoint of AUC 0-60min (Area under the curve during challenge) for %-fall in FEV 1: mean of 10.5% · hr [95%CI: 7.5, 13.4] and 14.7% · hr [11.8, 17.7] for montelukast and placebo, respectively. While the upper airway endpoint of AUC 0-60min for increased nasal symptoms score (NSS) on montelukast demonstrated a borderline (p=0.1) improvement, both the individual symptom of nasal congestion and the NSS during the recovery phase (30-min postchallenge) showed significant (p10%·hr (p=0.017) and similarly, against an upper airway reaction of AUC 0-60min-Increase-NSS >1.0 score · hr (p=0.039). Finally, montelukast demonstrated a simultaneous effect against lower and upper airway reactions, with significantly more patients (p=0.016) on montelukast (43.1%) vs placebo (25.5%) being protected from both asthma and rhinitis responses to cat allergen. In patients exhibiting simultaneous lower and upper airway responses to acute cat allergen challenge, montelukast protected against both asthma and rhinitis responses.