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 |