Risk factors for montelukast treatment failure in step-down therapy for controlled asthma

M. Bradley Drummond, Stephen P. Peters, Mario Castro, Janet Teresa Holbrook, Charles G. Irvin, Lewis J. Smith, Robert A Wise, Elizabeth Sugar

Research output: Contribution to journalArticle

Abstract

Background. Leukotriene receptor antagonists including montelukast are an option for step-down therapy for mild asthmatics controlled on low-dose inhaled corticosteroids (ICS). Because some patients fail montelukast step-down therapy, it would be helpful for clinicians to be able to predict the risk of treatment failure. Objectives. To determine patient characteristics associated with montelukast treatment failure and develop a clinical index to predict the risk of montelukast treatment failure. Methods. 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, we determined associations between enrollment variables and treatment failure. We constructed a montelukast failure index to predict the risk of montelukast treatment failure during step-down. To assess its specificity for montelukast, index performance was evaluated in the other LOCCS treatment groups. Results. Characteristics independently associated with montelukast treatment failure included age of asthma onset 5 predicted high risk (>0.60) of treatment failure. Conclusion. Early asthma onset, worse asthma control in the last year, and lower pre-bronchodilator FEV1 are associated with montelukast treatment failure. A montelukast failure index is proposed to quantify the risk of failure prior to treatment initiation.

Original languageEnglish (US)
Pages (from-to)1051-1057
Number of pages7
JournalJournal of Asthma
Volume48
Issue number10
DOIs
StatePublished - Dec 2011

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montelukast
Treatment Failure
Asthma
Adrenal Cortex Hormones
Therapeutics
Leukotrienes
Leukotriene Antagonists

Keywords

  • Asthma
  • Leukotrienes
  • Therapy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Immunology and Allergy
  • Pediatrics, Perinatology, and Child Health

Cite this

Risk factors for montelukast treatment failure in step-down therapy for controlled asthma. / Drummond, M. Bradley; Peters, Stephen P.; Castro, Mario; Holbrook, Janet Teresa; Irvin, Charles G.; Smith, Lewis J.; Wise, Robert A; Sugar, Elizabeth.

In: Journal of Asthma, Vol. 48, No. 10, 12.2011, p. 1051-1057.

Research output: Contribution to journalArticle

Drummond, M. Bradley ; Peters, Stephen P. ; Castro, Mario ; Holbrook, Janet Teresa ; Irvin, Charles G. ; Smith, Lewis J. ; Wise, Robert A ; Sugar, Elizabeth. / Risk factors for montelukast treatment failure in step-down therapy for controlled asthma. In: Journal of Asthma. 2011 ; Vol. 48, No. 10. pp. 1051-1057.
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