Untersuchung zum Karenzintervall von Montelukast vor inhalativer bronchialer Allergenprovokation

Background: Leukotrienes are potent bronchoconstrictive and proinflammatory mediators in bronchial asthma. In a previous study on 16 subjects with bronchial asthma (two randomized groups) we showed that montelukast (10 mgdaily) significantly suppressed allergen provocation with specific allergens (mites and pollen) (p = 0.0005). In a follow-up study we addressed the question as to when montelukast should be discontinued in order to avoid a relevant effect on inhalational bronchial allergen provocation. Method: At the end of the first study montelukast (10 mg daily) was given again to both groups (2 × 8 asthma patients) for 21 days. After a montelukast-free period of one and three days allergen provocation was repeated in the same manner and the results were compared with the historic baseline values without montelukast. Results: The provocation dose for allergens was reduced by 39% after a montelukast-free period of one day and by 67% after three days. Only after three days was the difference significant (p=0.017), at which time the control value was nearly reached again. Conclusion: We recommend that montelukast be discontinued at least three days prior to inhalational allergen provocation.