Background: The efficacy of a new pharmacologic agent
for asthma, in this instance the leukotriene receptor antagonist
montelukast, is determined in controlled trials in research subjects.
The utility of a new drug is determined by multiple uncontrollable
factors in individual patients.
Objective: To assess
the utility of montelukast in the management of persistent asthma.
Design: Observational, retrospective.
Setting: Suburban multispecialty medical clinic.
Methods: From April 1998, montelukast was prescribed for
110 patients with persistent but controlled asthma, primarily for the
corticosteroid-sparing effect. Outcomes after 1 year were determined
from audits of medical records and responses to questionnaires.
Results: At least 56% of patients continued receiving
montelukast for the entire year. However, compared to those
patients who had discontinued montelukast therapy, those who continued
receiving it had no difference in the use of inhaled or systemic
corticosteroid or inhaled β2-agonist therapy.
Conclusion: Montelukast had marginal utility in the
management of these adult patients with controlled persistent