Effects of montelukast (MK-0476), a new potent cysteinyl leukotriene (LTD4) receptor antagonist, in patients with chronic asthma

J Allergy Clin Immunol. 1996 Sep;98(3):528-34. doi: 10.1016/s0091-6749(96)70086-6.


Background: Cysteinyl leukotrienes mediate signs and symptoms of asthma. In a double-blind, placebo-controlled, crossover study, a new potent and specific cysteinyl leukotriene (LTD4) receptor antagonist, montelukast (MK-0476), was evaluated for tolerability and clinical efficacy in patients with chronic asthma (receiving and not receiving inhaled corticosteroids).

Methods: Twenty-nine nonsmoking patients with asthma (15 treated concomitantly with inhaled corticosteroids) with FEV1 percent predicted values between 50% to 80% received MK-0476, 200 mg, or placebo three times daily for 10 1/3 days (31 doses) in a random, crossover manner, after a 2-week, open, baseline period. Comparisons in FEV1 (mean percent change from baseline after the first and last dose), mean daily daytime asthma and nocturnal awakening scores, and mean daily beta-agonist use were made between treatment periods.

Results: Montelukast, compared with placebo, caused improvements in FEV1 (mean percentage point difference of the percentage change from baseline) 3 and 4 hours after dosing on day 1 (hour 3, 9.0%; 95% confidence interval [CI] 0.53, 18.72; hour four, 10.9%; 95% CI -0.25, 20.20) and day 11 (hour 3, 14.0%; 95% CI 0.76, 31.43; hour 4, 13.4%; 95% CI 1.24, 28.83). Reductions were observed in mean daily beta-agonist use (1.0 puff/day [95% CI -1.61, -0.26]), mean daytime symptom scores, and nocturnal awakenings over the 10 1/3 day treatment period. There were no important differences between the groups receiving and those not receiving inhaled corticosteroids. Montelukast was well tolerated with no serious clinical adverse events reported.

Conclusions: In this study Montelukast, 200 mg, administered three times daily for 10 1/3 days, compared with placebo, was generally well tolerated and resulted in significant improvement in chronic asthma, irrespective of the presence of inhaled corticosteroids.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetates / adverse effects
  • Acetates / therapeutic use*
  • Adolescent
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Chronic Disease
  • Cross-Over Studies
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Leukotriene Antagonists*
  • Leukotriene D4 / metabolism*
  • Male
  • Membrane Proteins*
  • Middle Aged
  • Quinolines / adverse effects
  • Quinolines / therapeutic use*
  • Receptors, Leukotriene*


  • Acetates
  • Adrenal Cortex Hormones
  • Leukotriene Antagonists
  • Membrane Proteins
  • Quinolines
  • Receptors, Leukotriene
  • Leukotriene D4
  • cysteinyl leukotriene receptor 2
  • leukotriene D4 receptor
  • montelukast