Lei Wei-Te, Lin Chien-Yu, Chu Szu-Hung, Fang Li-Ching, Kao Yu-Hsuan, Tsai Po-Li, Lin Yu-Wen, Sung Fung-Chang, Wu Shu-I
Division of Immunology, Rheumatology, and Allergy, Department of Pediatrics, Hsinchu Municipal MacKay Children's Hospital, Hsinchu 30070, Taiwan.
Division of Infectious Disease, Department of Pediatrics, Hsinchu Municipal MacKay Children's Hospital, Hsinchu 30070, Taiwan.
Pharmaceuticals (Basel). 2025 Mar 7;18(3):379. doi: 10.3390/ph18030379.
Asthma is one of the most common chronic diseases in children, and montelukast is widely prescribed to manage symptoms. However, concerns have emerged regarding its potential association with neuropsychiatric disorders. This study aims to investigate the impact of montelukast duration on neuropsychiatric risks in children with asthma. A cohort study was conducted using Taiwan's National Health Insurance Research Database (NHIRD), including children diagnosed with asthma between 2004 and 2007. A total of 14,606 children in the montelukast cohort and 8432 in the non-montelukast cohort were analyzed, with propensity score matching applied to reduce confounding bias. Neuropsychiatric outcomes, including Tics/Tourette's syndrome, were evaluated using Cox proportional hazard models. Overall, montelukast use did not increase the risk of neuropsychiatric disorders. However, among children aged 6-15 years, prolonged use beyond 63 days was associated with a significantly elevated risk of Tics/Tourette's syndrome, with a 2.6-fold increase observed in girls and a 1.8-fold increase in boys. Conversely, shorter montelukast use in children aged 0-6 years was linked to a lower risk of neuropsychiatric disorders. Although montelukast generally does not elevate neuropsychiatric risks, extended use in older children may increase the likelihood of developing Tics/Tourette's syndrome. These findings highlight the importance of cautious prescribing in pediatric asthma management. Further research is necessary to validate these associations and inform clinical decision making.
哮喘是儿童中最常见的慢性疾病之一，孟鲁司特被广泛用于控制症状。然而，人们对其与神经精神疾病的潜在关联产生了担忧。本研究旨在调查孟鲁司特使用时长对哮喘儿童神经精神风险的影响。利用台湾地区国民健康保险研究数据库（NHIRD）进行了一项队列研究，研究对象包括2004年至2007年间被诊断为哮喘的儿童。共分析了孟鲁司特队列中的14,606名儿童和非孟鲁司特队列中的8432名儿童，并应用倾向评分匹配法以减少混杂偏倚。使用Cox比例风险模型评估包括抽动秽语综合征在内的神经精神结局。总体而言，使用孟鲁司特并未增加神经精神疾病的风险。然而，在6至15岁的儿童中，使用超过63天与抽动秽语综合征的风险显著升高相关，女孩的风险增加了2.6倍，男孩增加了1.8倍。相反，0至6岁儿童较短时间使用孟鲁司特与较低的神经精神疾病风险相关。尽管孟鲁司特一般不会增加神经精神风险，但在大龄儿童中延长使用可能会增加患抽动秽语综合征的可能性。这些发现凸显了在儿童哮喘管理中谨慎开药的重要性。有必要进行进一步研究以验证这些关联并为临床决策提供依据。
