Montelukast in the Treatment of Bronchiolitis, A Multi-center, Randomized, hree-blind, Placebo-controlled Trial_Chinese Journal of Evidence-Based Medicine

Authors：

BAI Jun ¹ , XU Peiru ²

1. Department of Pediatrics, Maternity and Child Care Hospital of Nanhai District in Foshan, Foshan 528200, China;2. Urumqi Children’s Hospital, he First Ailiated Hospital of Xinjiang Medical University, Urumqi 830000, China;

Corresponding author：

Keywords：

Bronchiolitis; Asthma; Bronchial hyperresponsiveness; Montelukast; Infant

DOI：

10.7507/1672-2531.20100536

Video：

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Objective 　To study the efect of montelukast for improving bronchial hyperresponsiveness (BHR) in treatment of bronchiolitis.
Methods 　Four hundreds infants, 3 to 24 months old, hospitalized with acute bronchiolitis in three Hospitals (Urumqi Children’s Hospital, Pediatrics Department of First Ailiated Hospital of Xinjiang Medical University, and Pediatrics Department of Army General Hospital) from January, 2007 to January, 2008, were randomly assigned into four groups: placebo group (n=92), budesonide group (n=91), montelukast short-course group (7 days, n=88), and montelukast long-course group (28 days, n=90). Main outcome measure was BHR ater treatment, including recurrent bronchiolitis wheezing and asthma incidence rate. Secondary measures were changes in serum T-IgE level and eosinophilic cationic protein (ECP) level.
Results 　All four groups were comparable at baseline. No signiicant diferences were observed between placebo group and budesonide group in changes of serum T-IgE (F=6.17, P=0.00), ECP (F=8.13, P=0.00), recurrent post-bronchiolitis-wheezing (χ2=49.46, P=0.00) and asthma incidence rate (χ2=27.21, P=0.00). Ater treatment with montelukast, there was statistical signiicance in T-IgE and ECP level, times of recurrent bronchiolitis wheezing and asthma incidence rate, as follows, montelukast short-course group versus placebo group (F=12.56, P=0.00), montelukast short-course group versus budesonide group (F=7.22, P=0.00), montelukast long-course group versus placebo group (F=20.48, P=0.00), montelukast long-course group versus budesonide group (F=13.56, P=0.00), montelukast short-course group versus montelukast long-course group (F=1.04, P=0.00).
Conclusions 　Budesonide treatment for 7 days can not improve bronchial hyperresponsiveness induced by bronchiolitis, while montelukast does, that is, montelukast can decrease both the times of bronchiolitis wheezing and asthma incidence rate. Long-course treatment of montelukast is superior to that of short-course.

Citation： BAI Jun,XU Peiru. Montelukast in the Treatment of Bronchiolitis, A Multi-center, Randomized, hree-blind, Placebo-controlled Trial. Chinese Journal of Evidence-Based Medicine, 2010, 10(9): 1011-1015. doi: 10.7507/1672-2531.20100536 Copy

1.	美国儿科学会. 毛细支气管炎诊治指南. Pediatrics, 2006, 118(4): 1774.
2.	Wang SZ, Bao YZ, Rosenberger CL. IL-12 and IL-18 modulate inflammatory and immune responses to respiratory syncytial virus infection. Immunol, 2004, 173 (6): 4040-4049.
3.	Sigurs N, Bjamason R, Sigurbergason F, et al. Respiratory syucytial virus bronchiolitis in infancy is an important risk factor for asthma and allergy at age 7. Am J Respir Crit Care Med, 2000, 161: 1501-1507.
4.	Abul-Ainine A, Luyt D. Short term effects of adrenaline in bronchiolitis: a randomized controlled trial. Arch Dis Child, 2008, 86(4): 276-279.
5.	Van Woensel JB, Van Aalderen WM. Treatment for bronchiolitis: the story continues. Lancet, 2002, 360(9327): 101-102.
6.	Hendeison WR, Tang Lo, Chu ST, et al. A role for cystinyl leukotrienes in airway remodeling in a mouse asthma mode. Am J Respir Crit Care Med, 2002, 165: 108-116.
7.	胡亚美, 江载芳, 诸福棠. 主编. 实用儿科学. 第7版. 北京: 人民出版社, 2002, 1199-1201.
8.	颜虹. 主编. 医学统计学. 供8年制及7年制临床医学等专业用. 北京: 人民卫生出版社, 2005, 259.
9.	Law BJ, Carbonell-Estrany X, Simors EA. An update on respiratory Syncytial Virus epidemiology: a developed country perspective. Respir Med, 2002, 96(Suppl B): S1-7.
10.	Collins PL, MeIntosh K, Chnaoek RM. Respiratory Syncytial Viurs in Virology 3rd ed New York. Lippincott-Raven Publisher, 1996, 1313.
11.	Who ME, Majzoub JA. Asthma, steroids and growth. Eng J Med, 2000, 343(15): 1113-1114.
12.	Cade A, Brownlee KG, Corrway SP, et al. Randomised placebo controlled trial of nebulised corticostrolitis in acute resoiratory syncytial viral bronchiolitis. Arch Dis Child, 2000, 82: 126-130.
13.	Hans Bisgaard for the Study Group on Montelukast and Respiratory Syncytial Virus. A randomized trial of montelukast in respiratory syncytial virus postbronchiolitis. Respir Crit Care Med, 2003, 167(3): 379-383.
14.	Knorr B. Pharmacokinetics and safety of montelukast in children aged 3 to 6 months. Clin Pharmacol, 2006, 46(6): 620.
15.	Knorr B, Franchi LM, Bisgaard H, et al. Montolukast,a leukoyriene receotor antagonist, for the treatment of persistant asthma in children aged 2 to 5 years. Pediatrics, 2001, 108: E48.
16.	孙宝清, 钟南山. 儿童血清特异性IgE水平与过敏原皮试、气道反应性之间的关系. 上海免疫学杂志, 2000, 20(3): 178.

1. 美国儿科学会. 毛细支气管炎诊治指南. Pediatrics, 2006, 118(4): 1774.
2. Wang SZ, Bao YZ, Rosenberger CL. IL-12 and IL-18 modulate inflammatory and immune responses to respiratory syncytial virus infection. Immunol, 2004, 173 (6): 4040-4049.
3. Sigurs N, Bjamason R, Sigurbergason F, et al. Respiratory syucytial virus bronchiolitis in infancy is an important risk factor for asthma and allergy at age 7. Am J Respir Crit Care Med, 2000, 161: 1501-1507.
4. Abul-Ainine A, Luyt D. Short term effects of adrenaline in bronchiolitis: a randomized controlled trial. Arch Dis Child, 2008, 86(4): 276-279.
5. Van Woensel JB, Van Aalderen WM. Treatment for bronchiolitis: the story continues. Lancet, 2002, 360(9327): 101-102.
6. Hendeison WR, Tang Lo, Chu ST, et al. A role for cystinyl leukotrienes in airway remodeling in a mouse asthma mode. Am J Respir Crit Care Med, 2002, 165: 108-116.
7. 胡亚美, 江载芳, 诸福棠. 主编. 实用儿科学. 第7版. 北京: 人民出版社, 2002, 1199-1201.
8. 颜虹. 主编. 医学统计学. 供8年制及7年制临床医学等专业用. 北京: 人民卫生出版社, 2005, 259.
9. Law BJ, Carbonell-Estrany X, Simors EA. An update on respiratory Syncytial Virus epidemiology: a developed country perspective. Respir Med, 2002, 96(Suppl B): S1-7.
10. Collins PL, MeIntosh K, Chnaoek RM. Respiratory Syncytial Viurs in Virology 3rd ed New York. Lippincott-Raven Publisher, 1996, 1313.
11. Who ME, Majzoub JA. Asthma, steroids and growth. Eng J Med, 2000, 343(15): 1113-1114.
12. Cade A, Brownlee KG, Corrway SP, et al. Randomised placebo controlled trial of nebulised corticostrolitis in acute resoiratory syncytial viral bronchiolitis. Arch Dis Child, 2000, 82: 126-130.
13. Hans Bisgaard for the Study Group on Montelukast and Respiratory Syncytial Virus. A randomized trial of montelukast in respiratory syncytial virus postbronchiolitis. Respir Crit Care Med, 2003, 167(3): 379-383.
14. Knorr B. Pharmacokinetics and safety of montelukast in children aged 3 to 6 months. Clin Pharmacol, 2006, 46(6): 620.
15. Knorr B, Franchi LM, Bisgaard H, et al. Montolukast,a leukoyriene receotor antagonist, for the treatment of persistant asthma in children aged 2 to 5 years. Pediatrics, 2001, 108: E48.
16. 孙宝清, 钟南山. 儿童血清特异性IgE水平与过敏原皮试、气道反应性之间的关系. 上海免疫学杂志, 2000, 20(3): 178.

Chinese Journal of Evidence-Based Medicine

Montelukast in the Treatment of Bronchiolitis, A Multi-center, Randomized, hree-blind, Placebo-controlled Trial

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