Scaparrotta Alessandra, Di Pillo Sabrina, Attanasi Marina, Rapino Daniele, Cingolani Anna, Consilvio Nicola Pietro, Verini Marcello, Chiarelli Francesco
Allergy and Respiratory Unit, Department of Pediatrics, G, D'Annunzio University of Chieti, Via Dei Vestini 5, Chieti, 66013, Italy.
Multidiscip Respir Med. 2012 Jul 5;7(1):13. doi: 10.1186/2049-6958-7-13.
International guidelines recommend the use of inhaled corticosteroids (ICSs) as the preferred therapy, with leukotriene receptor antagonists (LTRAs) as an alternative, for the management of persistent asthma in children. Montelukast (MLK) is the first LTRA approved by the Food and Drug Administration for the use in young asthmatic children.Therefore, we performed an analysis of studies that compared the efficacy of MLK versus ICSs. We considered eligible for the inclusion randomized, controlled trials on pediatric populations with Jadad score > 3, with at least 4 weeks of treatment with MLK compared with ICS.Although it is important to recognize that ICSs use is currently the recommended first-line treatment for asthmatic children, MLK can have consistent benefits in controlling asthmatic symptoms and may be an alternative in children unable to use ICSs or suffering from poor growth. On the contrary, low pulmonary function and/or high allergic inflammatory markers require the corticosteroid use.
国际指南推荐使用吸入性糖皮质激素（ICS）作为首选治疗方法，对于儿童持续性哮喘的管理，白三烯受体拮抗剂（LTRA）作为替代药物。孟鲁司特（MLK）是美国食品药品监督管理局批准用于年轻哮喘儿童的首个LTRA。因此，我们对比较MLK与ICS疗效的研究进行了分析。我们认为符合纳入标准的是针对儿科人群的随机对照试验，Jadad评分>3，与ICS相比，MLK治疗至少4周。尽管必须认识到，目前ICS的使用是哮喘儿童推荐的一线治疗方法，但MLK在控制哮喘症状方面可产生持续的益处，对于无法使用ICS或生长发育不良的儿童可能是一种替代选择。相反，低肺功能和/或高过敏炎症标志物则需要使用糖皮质激素。
