Protection of leukotriene receptor antagonist against aspirin-induced bronchospasm in asthmatics.
- Author:
Jong Sook PARK
1
;
An Soo JANG
;
Sung Woo PARK
;
Young Mok LEE
;
Soo Taek UH
;
Yong Hoon KIM
;
Ji Yean CHA
;
Se Min PARK
;
Choon Sik PARK
Author Information
- Publication Type:Original Article
- Keywords: Asthma; leukotriene antagonists; aspirin; eosinophils
- MeSH: Acetates; Adult; Aspirin; Asthma; Asthma, Aspirin-Induced; Bronchial Spasm; Eosinophils; Humans; Hypersensitivity; Leukotriene Antagonists; Quinolines; Receptors, Leukotriene; Sinusitis
- From:Allergy, Asthma & Immunology Research 2010;2(1):48-54
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Leukotriene receptor antagonists (LTRAs) are used to treat aspirin-intolerant asthma (AIA); however, the protective effects of long-term LTRA administration against aspirin-induced bronchospasm have not been evaluated. OBJECTIVES: We investigated the efficacy of a 12-week treatment with a LTRA in protecting against aspirin-induced asthma in AIA patients. METHODS: Fifty-two adult patients with AIA underwent an aspirin challenge test just before administration of montelukast (10 mg/day) and just after 12 weeks of treatment. The protective effect was assessed as the disappearance of aspirin-induced bronchospasm after 12 weeks of treatment. The results were compared according to the patients' clinical and physiological parameters. RESULTS: The decline in FEV1 following aspirin challenge was significantly reduced from 28.6+/-1.9% to 10.2+/-1.7% (P=0.0001) after 12 weeks of montelukast treatment. However, 14 subjects (30%) still showed a positive response (>15% decline in FEV1) to aspirin challenge. Grouping the subjects into good and poor responders according to post-treatment responses revealed that the pretreatment aspirin-induced FEV1 decline was significantly greater in the poor responders and that the triggering dose of aspirin and the induction time for a positive response were lower and shorter, respectively, in the poor responders. Histories of aspirin hypersensitivity and sinusitis were more prevalent among the poor responders than among the good responders. CONCLUSIONS: Twelve weeks of treatment with montelukast protected against aspirin-induced bronchospasm in 70% of the AIA cases. A poor response was associated with more severe aspirin-induced bronchospasms before treatment and a history of aspirin hypersensitivity or sinusitis. CLINICAL IMPLICATIONS: A severe response to aspirin challenge may be a predictor of poor responsiveness to leukotriene antagonist treatment.
