Oral montelukast may have a role in severe and in life-threatening acute asthma.

摘要

In the wake of the clinical bottom line which read "Use of oral montelukast is not currently recommended in moderate to severe asthma exacerbations" in the article by Capsomidis and Tighe, new evidence has emerged suggesting a role for oral montelukast in hastening recovery of lung function following not only severe but also life-threatening acute asthma in adults of mean age 29.3 years who have had a diagnosis of asthma for a mean duration of 16.8 years. In that study where asthma severity was classified according to British Thoracic Society guidelines, subjects were randomised to oral montelukast (initiated on admission) or to placebo, in addition to 40 mg oral prednisolone and 6-hourly nebulised salbutamol and nebulised iprat-ropium bromide. Forty-nine per cent and 31% of those allocated to montelukast and placebo, respectively, belonged to the category of severe asthma, and 38% and 44% of those allocated to montelukast and placebo, respectively, belonged to the category of life-threatening asthma.