Asthma, Acute Asthma
Conditions
Keywords
Acute asthma, Children, Montelukast, Emergency room
Brief summary
The purpose of this study is to determine if adding single dose of oral montelukast to the standard treatment of systemic glucocorticoids plus short acting beta-2 agonist for treatment of acute wheezing provide additional clinical benefit in the emergency room.
Detailed description
Systemic corticosteroids and short acting beta-2 agonists are the mainstay treatment of acute asthma, however, little data exists regarding use of leukotriene antagonists in acute asthma. A few studies in adults have shown that oral montelukast also improved pulmonary function when being added to the standard treatment. But in school-age children this clinical benefit could not be demonstrated by adding montelukast to the standard treatment of acute asthma in emergency room. Moreover in preschool children there are no studies on this topic. The investigators hypothesized that addition of single dose of oral montelukast to standard therapy in acute moderate to severe wheezing may provide additional benefit in the meaning of improvement of pulmonary score and/or proportion of discharge from emergency department in preschool-age children.
Interventions
Children had received single dose of 4 mg oral montelukast after first dose of nebulized salbutamol and systemic glucocorticoids.
Children had received single dose of oral placebo montelukast granule after first dose of nebulized salbutamol and systemic glucocorticoids.
Sponsors
Study design
Eligibility
Inclusion criteria
* 6 months to 6 years of age * With at least three episodes of wheezing in the previous 12 months * Who presented to the ED with a moderate to severe wheezing episode (defined as a Pulmonary Index Score \[PIS\] of 7 to 13
Exclusion criteria
* Patients who were receiving more than 400 mcg of inhaled budesonide or equivalent per day * Who had any change in their dose of ICSs in the past 2 months * Who had taken systemic corticosteroid within 1 months * Patients who have concurrent pneumonia, croup or suspected foreign body aspiration, a history of cystic fibrosis, bronchopulmonary dysplasia, bronchiolitis obliterans, congenital heart disease, liver or renal disease,sickle cell anemia or immune deficiency were excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Difference of pulmonary index score from baseline to 120 minutes. | 0 to 120 minutes | İmprovment of pulmonary index score from 0 to 120 minutes was compared bwtween the montelukast and placebo groups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of discharge from emergency department. | 120, 180 and 240. minutes | Proportion of subjects who were discharged from emergency department at 120,180 and 240. minutes were compared between the montelukast and placebo groups. |
Countries
Turkey (Türkiye)