Wahn Ulrich, Dass S Balachandra
Charité Universitätsmedizin, Department for Pediatric Pneumology and Immunology, Berlin, Germany.
Clin Ther. 2008;30 Spec No:1026-35. doi: 10.1016/j.clinthera.2008.05.018.
Asthma is a chronic disease with a heterogeneous phenotype that is often associated with allergic sensitization in childhood. The earliest definable form of asthma is mild (intermittent or persistent), a severity level that may be characteristic of a majority of children with asthma. Several asthma controllers are indicated for use in children. International guidelines recommend the use of inhaled corticosteroids as the preferred controller therapy in mild persistent asthma.
This article reviewed recent results from randomized, double-blind studies of children with mild asthma treated with montelukast, a leukotriene receptor antagonist that is approved for the treatment of asthma and allergic rhinitis in children and adults.
A literature search of MEDLINE was conducted to gather relevant, English-language articles using search terms such as randomized controlled studies, double-blind studies, montelukast, leukotriene receptor antagonist, pediatric asthma, mild asthma, exercise-induced asthma, and bronchoconstriction. Recent articles (since 1998) that described the use of montelukast as a monotherapy were chosen for this review.
Relevant studies included a 48-week, placebo-controlled study of 2- to 5-year-old mild intermittent asthmatics (N = 549); a 12-week, placebo-controlled study of 2- to 5-year-old mild persistent asthmatics (N = 689); an analysis of a mild persistent asthmatic cohort (N = 138) from an 8-week, placebo-controlled study of 6- to 14-year-old asthmatics; a 12-month study comparing montelukast with fluticasone in 6- to 14-year-old mild persistent asthmatics (N = 949); and 3 placebo-controlled studies in children with exercise-induced asthma (N = 123). The results from these studies, encompassing end points measuring lung function and symptoms, found that montelukast provided effective and beneficial asthma control to children aged 2 to 14 years with mild asthma.
The evidence suggests that montelukast is an effective monotherapy controller in children with mild asthma.
哮喘是一种具有异质性表型的慢性疾病，常与儿童期的过敏致敏相关。哮喘最早可定义的形式为轻度（间歇性或持续性），这一严重程度可能是大多数哮喘儿童的特征。有几种哮喘控制药物被批准用于儿童。国际指南推荐吸入性糖皮质激素作为轻度持续性哮喘的首选控制疗法。
本文回顾了孟鲁司特治疗轻度哮喘儿童的随机双盲研究的近期结果。孟鲁司特是一种白三烯受体拮抗剂，已被批准用于治疗儿童和成人的哮喘及过敏性鼻炎。
在MEDLINE数据库中进行文献检索，使用随机对照研究、双盲研究、孟鲁司特、白三烯受体拮抗剂、儿童哮喘、轻度哮喘、运动诱发性哮喘和支气管收缩等检索词收集相关英文文章。选择1998年以来描述孟鲁司特单药治疗的近期文章进行本综述。
相关研究包括一项针对2至5岁轻度间歇性哮喘患儿的48周安慰剂对照研究（N = 549）；一项针对2至5岁轻度持续性哮喘患儿的12周安慰剂对照研究（N = 689）；一项对6至14岁哮喘患儿进行的8周安慰剂对照研究中轻度持续性哮喘队列（N = 138）的分析；一项在6至14岁轻度持续性哮喘患儿中比较孟鲁司特与氟替卡松的12个月研究（N = 949）；以及3项针对运动诱发性哮喘儿童的安慰剂对照研究（N = 123）。这些研究的结果，包括测量肺功能和症状的终点指标，发现孟鲁司特可为2至14岁轻度哮喘儿童提供有效且有益的哮喘控制。
证据表明孟鲁司特是轻度哮喘儿童有效的单药控制药物。
