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A double-blind, placebo-controlled trial of montelukast in adult atopic eczema

A double-blind, placebo-controlled trial of montelukast in adult atopic eczema
A double-blind, placebo-controlled trial of montelukast in adult atopic eczema
Background Montelukast is an antagonist of cys-leukotriene receptors used mainly in the treatment of asthma- and seasonal-allergic rhinitis. Initial reports concerning the use of montelukast in atopic dermatitis (AD) have been encouraging, although not consistent. Objectives We have undertaken a randomized, double-blind, parallel-group, placebo-controlled trial to investigate further the efficacy of montelukast in the treatment of atopic eczema. Methods Following a screening visit, subjects received placebo treatment for 2 weeks in a single-blind phase, followed after visit 2 by an 8-week, double-blind period of treatment with montelukast 10 mg daily or placebo. Subjects were patients aged 16-60 years under our care for treatment of AD of moderate severity, defined by a six-area, six-sign atopic dermatitis (SASSAD) score in the range 12-50. Response to treatment was assessed by investigators and by subjects using a seven-point scale, with response defined as marked improvement or better. In addition, the SASSAD score was used to monitor the severity of clinical signs. The proportion of skin involved was estimated and visual analogue scales were used to record the severity of pruritus and sleep disturbance. Topical corticosteroid usage was recorded using a five-point scale. Adverse events were recorded. Results Sixty subjects were recruited and 54 completed the study. The treatment groups were well matched for disease severity at baseline (SASSAD scores were 25 and 29 in the montelukast and placebo groups, respectively). There were no significant differences between the treatment groups in any of the parameters used to assess treatment response. The improvement in mean SASSAD score from baseline (visit 2) to the end of treatment was marginally superior in the placebo group, 1.41 points on montelukast vs. 1.76 on placebo, a difference of 0.35 (95% confidence interval -6.1 to 6.8). Adverse events were generally of a mild nature except for a brief septicaemic illness in one subject receiving montelukast. Conclusions The data do not support previous reports of efficacy of montelukast in treatment of AD.
atopic dermatitis, eczema, montelukast, randomized double-blind placebo-controlled trial, SASSAD
0954-7894
1536-1540
Friedmann, P.S.
d50bac23-f3ec-4493-8fa0-fa126cbeba88
Palmer, R.
1ae45e5e-32d6-4983-9d28-b8c252c3b787
Tan, E.
8fbfdc39-47db-435b-ad14-20abd84f2415
Ogboli, M.
562655af-ae73-4053-a53b-5e1835906712
Barclay, G.
3c1839ee-6ed3-49af-8ed1-0bc3bdc2b271
Hotchkiss, K.
4013b2c0-4e9f-45c0-a0d8-8b3c4bd794d0
Berth-Jones, J.
cd73c0c9-25a6-4954-b2b3-5172b6d135a9
Friedmann, P.S.
d50bac23-f3ec-4493-8fa0-fa126cbeba88
Palmer, R.
1ae45e5e-32d6-4983-9d28-b8c252c3b787
Tan, E.
8fbfdc39-47db-435b-ad14-20abd84f2415
Ogboli, M.
562655af-ae73-4053-a53b-5e1835906712
Barclay, G.
3c1839ee-6ed3-49af-8ed1-0bc3bdc2b271
Hotchkiss, K.
4013b2c0-4e9f-45c0-a0d8-8b3c4bd794d0
Berth-Jones, J.
cd73c0c9-25a6-4954-b2b3-5172b6d135a9

Friedmann, P.S., Palmer, R., Tan, E., Ogboli, M., Barclay, G., Hotchkiss, K. and Berth-Jones, J. (2007) A double-blind, placebo-controlled trial of montelukast in adult atopic eczema. Clinical & Experimental Allergy, 37 (10), 1536-1540. (doi:10.1111/j.1365-2222.2007.02811.x).

Record type: Article

Abstract

Background Montelukast is an antagonist of cys-leukotriene receptors used mainly in the treatment of asthma- and seasonal-allergic rhinitis. Initial reports concerning the use of montelukast in atopic dermatitis (AD) have been encouraging, although not consistent. Objectives We have undertaken a randomized, double-blind, parallel-group, placebo-controlled trial to investigate further the efficacy of montelukast in the treatment of atopic eczema. Methods Following a screening visit, subjects received placebo treatment for 2 weeks in a single-blind phase, followed after visit 2 by an 8-week, double-blind period of treatment with montelukast 10 mg daily or placebo. Subjects were patients aged 16-60 years under our care for treatment of AD of moderate severity, defined by a six-area, six-sign atopic dermatitis (SASSAD) score in the range 12-50. Response to treatment was assessed by investigators and by subjects using a seven-point scale, with response defined as marked improvement or better. In addition, the SASSAD score was used to monitor the severity of clinical signs. The proportion of skin involved was estimated and visual analogue scales were used to record the severity of pruritus and sleep disturbance. Topical corticosteroid usage was recorded using a five-point scale. Adverse events were recorded. Results Sixty subjects were recruited and 54 completed the study. The treatment groups were well matched for disease severity at baseline (SASSAD scores were 25 and 29 in the montelukast and placebo groups, respectively). There were no significant differences between the treatment groups in any of the parameters used to assess treatment response. The improvement in mean SASSAD score from baseline (visit 2) to the end of treatment was marginally superior in the placebo group, 1.41 points on montelukast vs. 1.76 on placebo, a difference of 0.35 (95% confidence interval -6.1 to 6.8). Adverse events were generally of a mild nature except for a brief septicaemic illness in one subject receiving montelukast. Conclusions The data do not support previous reports of efficacy of montelukast in treatment of AD.

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More information

Published date: 10 September 2007
Keywords: atopic dermatitis, eczema, montelukast, randomized double-blind placebo-controlled trial, SASSAD

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Local EPrints ID: 59300
URI: http://eprints.soton.ac.uk/id/eprint/59300
ISSN: 0954-7894
PURE UUID: af6c3b35-d8a1-496d-9be4-52c093580697

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Date deposited: 02 Sep 2008
Last modified: 27 Apr 2022 08:47

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Contributors

Author: P.S. Friedmann
Author: R. Palmer
Author: E. Tan
Author: M. Ogboli
Author: G. Barclay
Author: K. Hotchkiss
Author: J. Berth-Jones

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