Montelukast as an adjunct to oral and inhaled steroid therapy in chronic nasal polyposis.

Author(s): Stewart RA, Ram B, Hamilton G, Weiner J, Kane KJ

Affiliation(s): Department of Otolaryngology, Royal Victorian Eye & Ear Hospital, Melbourne, Australia.

Publication date & source: 2008-11, Otolaryngol Head Neck Surg., 139(5):682-7.

Publication type: Randomized Controlled Trial

OBJECTIVE: To examine the potential of montelukast, a leukotriene receptor antagonist, as an adjunct to oral and inhaled steroid in subjects with chronic nasal polyps. STUDY DESIGN: Prospective, randomized controlled trial. SUBJECTS AND METHODS: Thirty-eight consecutive adult patients with bilateral nasal polyps were randomized into two groups. Eighteen subjects were treated with oral prednisolone for 14 days and budenoside nasal spray for 8 weeks. Twenty subjects received similar treatment with additional oral montelukast for 8 weeks. Subjects completed a modified nasal ICSD symptom score at 8 and 12 weeks after beginning treatment and the SF-36 quality of life questionnaire at 12 weeks. RESULTS: Symptom scores improved in both groups after treatment. Subjects treated with montelukast reported significantly less headache (P = 0.013), facial pain (P = 0.048) and sneezing (P = 0.03) than controls. Four weeks after completing treatment, no significant differences were recorded. CONCLUSION: Montelukast therapy may have clinical benefit as an adjunct to oral and inhaled steroid in chronic nasal polyposis, but effects are not maintained after cessation of treatment.