Document Detail


An open audit of montelukast, a leukotriene receptor antagonist, in nasal polyposis associated with asthma.
MedLine Citation:
PMID:  11591188     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Nasal polyposis occurs frequently in patients with intrinsic asthma, especially in those who are aspirin sensitive. It can be difficult to treat effectively, even with surgery and regular topical intranasal corticosteroids many patients are still symptomatic. OBJECTIVE: To investigate the response to montelukast, a leukotriene D4 receptor antagonist, as an add-on therapy to topical and inhaled corticosteroids in patients, both aspirin sensitive (AS) and aspirin tolerant (AT), with nasal polyposis and asthma. METHODS: Nasal polyposis symptoms were assessed by visual analogue scales; nasal polyps were assessed by nasendoscopy and via the measurement of nasal volumes by acoustic rhinometry. The nasal airway was assessed by nasal inspiratory peakflow (NIPF). Asthma was monitored using symptom scores and peak expiratory flow measurements. Aspirin sensitivity was assessed by history together with intranasal lysine aspirin challenge. Upper and lower airway nitric oxide measurements were made before and during treatment. RESULTS: Clinical subjective improvement in nasal polyposis occurred in 64% AT (P < 0.01), patients and 50% AS patients (P > 0.05); asthma improvement in 87% AT and 61% AS patients (P < 0.05 for both). Objective changes in peak flow occurred only in AT patients (P < 0.05). Acoustic rhinometry, nasal inspiratory peak flow and nitric oxide levels did not change significantly in any group, however, correlations were seen between nitric oxide levels and polyp scores and between nitric oxide levels and acoustic rhinometry changes. Improvement on montelukast therapy was not associated with any of the following variables: age, sex, skin prick test positivity, disease duration or aspirin sensitivity. (P > 0.05 for all). CONCLUSION: The findings are consistent with a subgroup of nasal polyps/asthma patients in whom leukotriene receptor antagonists are effective. This is not related to aspirin sensitivity. Further placebo-controlled studies need to be undertaken.
Authors:
S Ragab; A Parikh; Y C Darby; G K Scadding
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology     Volume:  31     ISSN:  0954-7894     ISO Abbreviation:  Clin. Exp. Allergy     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-10-09     Completed Date:  2001-12-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8906443     Medline TA:  Clin Exp Allergy     Country:  England    
Other Details:
Languages:  eng     Pagination:  1385-91     Citation Subset:  IM    
Affiliation:
Royal National Throat, Nose and Ear Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Acetates / therapeutic use*
Adult
Aged
Anti-Asthmatic Agents / therapeutic use*
Anti-Inflammatory Agents, Non-Steroidal / adverse effects,  therapeutic use
Aspirin / adverse effects,  therapeutic use
Asthma / chemically induced,  complications*,  drug therapy*
Bleeding Time
Female
Humans
Inspiratory Capacity / drug effects,  physiology
Leukotriene Antagonists / therapeutic use*
Male
Middle Aged
Nasal Polyps / complications*,  drug therapy*
Nitric Oxide / metabolism
Peak Expiratory Flow Rate / drug effects,  physiology
Quinolines / therapeutic use*
Sensitivity and Specificity
Skin Tests
Chemical
Reg. No./Substance:
0/Acetates; 0/Anti-Asthmatic Agents; 0/Anti-Inflammatory Agents, Non-Steroidal; 0/Leukotriene Antagonists; 0/Quinolines; 10102-43-9/Nitric Oxide; 158966-92-8/montelukast; 50-78-2/Aspirin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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