Up to 30% of patients require hospitalization for acute asthma despite standard therapy in the emergency department. In adults, intravenous montelukast added to standard therapy significantly improved forced expiratory volume in 1 second (FEV1) and reduced hospital admissions.
This was a randomized, double-blind, placebo-controlled, multicenter study of children aged 6 to 14 years. Patients with an FEV1 of 75% or less of the predicted value after 2 hours of standard therapy (e.g., oxygen, albuterol, inhaled anticholinergics, and systemic oral corticosteroids) were randomized to intravenous montelukast, 5.25 mg or placebo. Montelukast is available in the U.S. in oral form as Singulair.
Montelukast was not significantly more effective than placebo for FEV1 when added to standard therapy (0.08 vs. 0.07 L).
In this study of children with acute asthma, intravenous montelukast was not significantly better than placebo in improving FEV1, symptoms, or overall hospital course.
A randomized, placebo-controlled study of intravenous montelukast in children with acute asthma. Morris CR, Becker AB, Piñieiro A, Massaad R, Green SA, Smugar SS, Gurner DM. Ann Allergy Asthma Immunol. 2010 Feb;104(2):161-71.