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Table 1 Studies of preschool wheezing children treated with montelukast alone or with inhaled corticosteroids (ICS)

From: Update on leukotriene receptor antagonists in preschool children wheezing disorders

  Author Pros Cons
  Bisgaard[30] Protection against cold air-induced reactivity  
  Hakim[22] Reduced methacoline-induced reactivity  
Wheezing (short-term Straub[31] Reduced airway resistance and exhaled nitric oxide  
montelukast monotherapy) Straub[32] Improved lung function and symptom score  
  Robertson[33] Reduced healthcare resource use, symptoms, time-off school/parent work No effect on hospitalization rate, symptoms duration, β2 or steroids use
  Szefler[38] No difference versus budesonide for Higher rates of exacerbations
   - time to 1st additional asthma drug at 12 weeks  
   - time to 1st attack requiring oral steroid  
Wheezing (long-term Kooi[39] Montelukast versus fluticasone or placebo  
montelukast   In all groups In all groups: no differences
monotherapy)   - Improved symptoms score in lung function
   - Reduced blood eosinophils  
  Allen-Ramey[41] Emergency visits fewer versus fluticasone No differences in hospitalizations or rescue drugs
  Davies[35] Similar rates of healthcare resource of cromolyn or ICS  
  Bisgaard[36] Lower  
   - rate of asthma exacerbations  
   - median time to first exacerbation  
   - rate of ICS courses  
  Bacharier[40]   No difference in symptom free-days, oral steroid, healthcare resource use
Wheezing Johnston Reduced risk of :  
(montelukast + ICS) [44] - worsened asthma symptoms  
   - unscheduled physician visits  
  1. References are in parenthesis.