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Monday, November 14, 2011

Can we predict montelukast treatment failure in step-down therapy for controlled asthma?

Although many physicians and patients want to replace low dose inhaled steroids with montelukast in controlled patients with mild asthma, there are insufficient data to predict montelukast failure. A study by Drummond et al (J Asthma 2011 Oct 27 [Epub ahead of print]) provides a piece of the puzzle. Using the 165 participants in the Leukotriene or Corticosteroid or Corticosteroid-Salmeterol Study (LOCCS) trial who were stepped down from low-dose ICS to montelukast, the authors attempted to predict the risk of montelukast treatment failure during step-down. Characteristics independently associated with montelukast treatment failure included early asthma onset (<10 years), need for steroid burst in the last year, and low pre-bronchodilator FEV1. They constructed a montelukast failure index that may prove to be helpful for clinical practice, but it needs further validation.

2 comments:

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