The Experts below are selected from a list of 8553 Experts worldwide ranked by ideXlab platform
Theodore F Reiss - One of the best experts on this subject based on the ideXlab platform.
-
a placebo controlled dose ranging study of montelukast a cysteinyl Leukotriene Receptor antagonist
The Journal of Allergy and Clinical Immunology, 1998Co-Authors: Leonard C Altman, Ji Zhang, Zev M Munk, James M Seltzer, Nancy Noonan, Sumiko Shingo, Theodore F ReissAbstract:Abstract Background: The cysteinyl Leukotrienes are important mediators of bronchial asthma. The clinical effect of montelukast, a potent cysteinyl Leukotriene–Receptor antagonist, was investigated in a randomized, placebo-controlled, multicenter, parallel-group, dose-ranging study. Methods: After a 3-week, single-blind, placebo run-in period, 343 asthmatic patients (FEV 1 40% to 80% of the predicted value with an improvement in FEV 1 of at least 15% [absolute value] after receiving inhaled β-agonists on at least two occasions) were randomly assigned to one of six treatment groups: placebo; 10, 100, or 200 mg once daily montelukast in the evening; or 10 or 50 mg twice daily montelukast for a 6-week, double-blind treatment period followed by a 1-week placebo washout period. All patients used inhaled, short-acting β-agonists as needed. Results: All montelukast doses caused similar and significant differences compared with placebo in asthma control endpoints. The least-square mean difference between pooled montelukast groups and placebo in the percentage change from baseline in morning FEV 1 (10.30%; 95% CI: 5.56 to 15.04), as-needed β-agonist use (–0.98 puffs; 95% CI: –1.53 to –0.44), morning peak expiratory flow rate (18.80 L/min; 95% CI: 8.62 to 28.98), physicians' and patients' global evaluations, and asthma-specific quality-of-life scores were all significant ( p ≤ 0.050). The incidence of adverse experiences was not dose related and was similar between placebo and montelukast treatment. Conclusion: Montelukast caused a significant improvement in chronic asthma at an oral, once daily evening dose as low as 10 mg. (J Allergy Clin Immunol 1998;102:50-6.)
-
montelukast a potent Leukotriene Receptor antagonist causes dose related improvements in chronic asthma montelukast asthma study group
European Respiratory Journal, 1998Co-Authors: M J Noonan, Paul Chervinsky, M Brandon, Ji Zhang, S Kundu, J Mcburney, Theodore F ReissAbstract:The Leukotrienes are known to be important mediators of bronchial asthma. The ability of montelukast, a potent and selective CysLT1 Leukotriene Receptor antagonist, to cause a dose-related improvement in chronic asthma was investigated in a placebo-controlled, multicentre, parallel-group study. After a two week placebo run-in period, chronic asthmatic patients with a forced expiratory volume in one second (FEV1) 40-80% predicted with > or = 15% increase (absolute value) after beta2-agonist were randomly assigned to one of four treatment groups (placebo or montelukast 2, 10, or 50 mg once daily in the evening) for a three week, double-blind treatment period. For patient-reported end-points (daytime symptom score, use of as needed inhaled beta2 agonist, asthma-specific quality of life) and frequency of asthma exacerbations, montelukast 10 and 50 mg caused similar responses, superior to 2 mg and significantly (p
-
increased urinary excretion of lte4 after exercise and attenuation of exercise induced bronchospasm by montelukast a cysteinyl Leukotriene Receptor antagonist
Thorax, 1997Co-Authors: Theodore F Reiss, Ji Zhang, Edwin A Bronsky, James B Hill, Eloise Harman, Wesley K Tanaka, Debra Guerreiro, Leslie HendelesAbstract:BACKGROUND: A study was undertaken to determine whether montelukast, a new potent cysteinyl Leukotriene Receptor antagonist, attenuates exercise-induced bronchoconstriction. The relationship between the urinary excretion of LTE4 and exercise-induced bronchoconstriction was also investigated. METHODS: Nineteen non-smoking asthmatic patients with a forced expiratory volume in one second (FEV1) of > or = 65% of the predicted value and a reproducible fall in FEV1 after exercise of at least 20% were enrolled. Subjects received placebo and montelukast 100 mg once daily in the evening or 50 mg twice daily, each for two days, in a three-period, randomised, double blind, crossover design. In the evening, approximately 20-24 hours after the once daily dose or 12 hours after the twice daily dose, a standardised exercise challenge was performed. Data from 14 patients were available for complete analysis. RESULTS: The mean (SD) maximal percentage decrease in FEV1 after exercise was 29.6 (16.0), 17.1 (8.2), and 14.0 (9.4) for placebo, once daily, and twice daily regimens, respectively. The mean (95% CI) percentage protection was 37 (15 to 59) for the group who received 50 mg twice daily and 50 (31 to 69) for those who received 100 mg once daily. Active treatments were not different from each other. The mean (SD) plasma concentrations of montelukast were higher after the twice daily regimen (1.27 (0.81) microgram/ml) than after the once daily regimen (0.12 (0.09) microgram/ml); there was no correlation between the percentage protection against exercise-induced bronchoconstriction and plasma concentrations. After exercise urinary excretion of LTE4 increased significantly during placebo treatment (from 34.3 to 73.7 pg/mg creatinine; p < 0.05) but did not correlate with the extent of exercise-induced bronchoconstriction. CONCLUSIONS: Montelukast protects similarly against exercise-induced bronchoconstriction between plasma concentrations of 0.12 and 1.27 micrograms/ml. The increase in the urinary excretion of LTE4 after exercise and the protection from exercise-induced bronchoconstriction with a cysteinyl Leukotriene Receptor antagonist provide further evidence of the role of Leukotrienes in the pathogenesis of exercise-induced bronchoconstriction.
Karina A. Keogh - One of the best experts on this subject based on the ideXlab platform.
-
Leukotriene Receptor antagonists and Churg-Strauss syndrome: cause, trigger or merely an association?
Drug Safety, 2013Co-Authors: Karina A. KeoghAbstract:Concern has been raised in the medical literature that the use of Leukotriene Receptor antagonists for the treatment of asthma may be associated with an increased incidence of Churg-Strauss syndrome, a rare small-vessel vasculitic syndrome. This review provides a critical appraisal of the literature to address this question. The incidence of Churg-Strauss syndrome in the general population is one to four cases per million. In patients with asthma it is 20–60 cases per million patient-years, which is similar to that seen in a population receiving Leukotriene Receptor antagonists. There is no evidence for a direct causative role of Leukotriene Receptor antagonists in the development of Churg-Strauss syndrome. There may be multiple other non-causative reasons for an association, including the fact that these agents may be initiated in patients who are already in the process of developing Churg-Strauss syndrome, or that the use of Leukotriene Receptor antagonists leads to a reduction in corticosteroid use, which in turn allows the Churg-Strauss syndrome to be ‘unmasked’.
-
churg strauss syndrome clinical presentation antineutrophil cytoplasmic antibodies and Leukotriene Receptor antagonists
The American Journal of Medicine, 2003Co-Authors: Karina A. Keogh, Ulrich SpecksAbstract:PURPOSE: To determine the association of antineutrophil cytoplasmic antibodies (ANCA) and Leukotriene Receptor antagonists with disease activity in a large series of patients with Churg-Strauss syndrome. METHODS: Potential subjects were identified by a computerized search of the Mayo Clinic Rochester database for the years 1990 to 2000. Patients meeting one of three classification schemes for Churg-Strauss syndrome were included. RESULTS: Ninety-one patients met the inclusion criteria. Clinical manifestations were similar to those in previous reports. Mortality was similar to that in the general population. ANCA testing was performed in 74 patients. Seventy-three percent (n = 22) of the 30 patients tested before therapy were ANCA positive, as were 75% (n = 12) of the 16 patients tested during a disease flare. In comparison, 16% (n = 8) of the 49 tested during remission were ANCA positive. Serial measurements indicated a correlation of ANCA levels with disease activity. Central nervous system involvement was the only clinical manifestation that correlated with ANCA status (P = 0.05). Twenty-three patients received Leukotriene Receptor antagonists, of whom 16 (70%) began treatment before diagnosis and 6 (27%) began during remission. Two of those treated after diagnosis relapsed. In 1 patient the relation between disease and Leukotriene Receptor antagonist use could not be determined. Use of Leukotriene Receptor antagonists did not affect the time between onset of asthma and manifestations of vasculitis, and was not correlated with organ manifestations, except sinus disease. CONCLUSION: No one classification scheme identified all patients. Churg-Strauss syndrome has a better prognosis than other ANCA-associated vasculitides. ANCA status correlates with disease activity, whereas a pathogenic role for Leukotriene Receptor antagonists in the development of Churg-Strauss syndrome was not noted.
Aurora Bueno Cavanillas - One of the best experts on this subject based on the ideXlab platform.
-
The Leukotriene Receptor antagonist montelukast and its possible role in the cardiovascular field
European Journal of Clinical Pharmacology, 2017Co-Authors: Malvina Hoxha, G. Enrico Rovati, Aurora Bueno CavanillasAbstract:Background Cysteinyl Leukotrienes (LTC4, LTD4, and LTE4) are pro-inflammatory mediators of the 5-lipooxygenase (5-LO) pathway, that play an important role in bronchoconstriction, but can also enhance endothelial cell permeability and myocardial contractility, and are involved in many other inflammatory conditions. In the late 1990s, Leukotriene Receptor antagonists (LTRAs) were introduced in therapy for asthma and later on, approved for the relief of the symptoms of allergic rhinitis, chronic obstructive pulmonary disease, and urticaria. In addition, it has been shown that LTRAs may have a potential role in preventing atherosclerosis progression. Purpose The aims of this short review are to delineate the potential cardiovascular protective role of a LTRA, montelukast, beyond its traditional use, and to foster the design of appropriate clinical trials to test this hypothesis. Results and Conclusions What it is known about Leukotriene Receptor antagonists? •Leukotriene Receptor antagonist, such as montelukast and zafirlukast, is used in asthma, COPD, and allergic rhinitis. • Montelukast is the most prescribed CysLT_1 antagonist used in asthmatic patients. • Different in vivo animal studies have shown that Leukotriene Receptor antagonists can prevent the atherosclerosis progression, and have a protective role after cerebral ischemia. What we still need to know? • Today, there is a need for conducting clinical trials to assess the role of montelukast in reducing cardiovascular risk and to further understand the mechanism of action behind this effect.
-
the Leukotriene Receptor antagonist montelukast and its possible role in the cardiovascular field
European Journal of Clinical Pharmacology, 2017Co-Authors: Malvina Hoxha, Enrico G Rovati, Aurora Bueno CavanillasAbstract:Background Cysteinyl Leukotrienes (LTC4, LTD4, and LTE4) are pro-inflammatory mediators of the 5-lipooxygenase (5-LO) pathway, that play an important role in bronchoconstriction, but can also enhance endothelial cell permeability and myocardial contractility, and are involved in many other inflammatory conditions. In the late 1990s, Leukotriene Receptor antagonists (LTRAs) were introduced in therapy for asthma and later on, approved for the relief of the symptoms of allergic rhinitis, chronic obstructive pulmonary disease, and urticaria. In addition, it has been shown that LTRAs may have a potential role in preventing atherosclerosis progression.
Malvina Hoxha - One of the best experts on this subject based on the ideXlab platform.
-
The Leukotriene Receptor antagonist montelukast and its possible role in the cardiovascular field
European Journal of Clinical Pharmacology, 2017Co-Authors: Malvina Hoxha, G. Enrico Rovati, Aurora Bueno CavanillasAbstract:Background Cysteinyl Leukotrienes (LTC4, LTD4, and LTE4) are pro-inflammatory mediators of the 5-lipooxygenase (5-LO) pathway, that play an important role in bronchoconstriction, but can also enhance endothelial cell permeability and myocardial contractility, and are involved in many other inflammatory conditions. In the late 1990s, Leukotriene Receptor antagonists (LTRAs) were introduced in therapy for asthma and later on, approved for the relief of the symptoms of allergic rhinitis, chronic obstructive pulmonary disease, and urticaria. In addition, it has been shown that LTRAs may have a potential role in preventing atherosclerosis progression. Purpose The aims of this short review are to delineate the potential cardiovascular protective role of a LTRA, montelukast, beyond its traditional use, and to foster the design of appropriate clinical trials to test this hypothesis. Results and Conclusions What it is known about Leukotriene Receptor antagonists? •Leukotriene Receptor antagonist, such as montelukast and zafirlukast, is used in asthma, COPD, and allergic rhinitis. • Montelukast is the most prescribed CysLT_1 antagonist used in asthmatic patients. • Different in vivo animal studies have shown that Leukotriene Receptor antagonists can prevent the atherosclerosis progression, and have a protective role after cerebral ischemia. What we still need to know? • Today, there is a need for conducting clinical trials to assess the role of montelukast in reducing cardiovascular risk and to further understand the mechanism of action behind this effect.
-
the Leukotriene Receptor antagonist montelukast and its possible role in the cardiovascular field
European Journal of Clinical Pharmacology, 2017Co-Authors: Malvina Hoxha, Enrico G Rovati, Aurora Bueno CavanillasAbstract:Background Cysteinyl Leukotrienes (LTC4, LTD4, and LTE4) are pro-inflammatory mediators of the 5-lipooxygenase (5-LO) pathway, that play an important role in bronchoconstriction, but can also enhance endothelial cell permeability and myocardial contractility, and are involved in many other inflammatory conditions. In the late 1990s, Leukotriene Receptor antagonists (LTRAs) were introduced in therapy for asthma and later on, approved for the relief of the symptoms of allergic rhinitis, chronic obstructive pulmonary disease, and urticaria. In addition, it has been shown that LTRAs may have a potential role in preventing atherosclerosis progression.
Krishnan Parameswaran - One of the best experts on this subject based on the ideXlab platform.
-
Leukotriene Receptor antagonists for allergic rhinitis a systematic review and meta analysis
The American Journal of Medicine, 2004Co-Authors: Andrew M Wilson, Paul M Obyrne, Krishnan ParameswaranAbstract:Abstract Purpose To compare the clinical efficacy of Leukotriene Receptor antagonists with that of placebo, antihistamines, and nasal corticosteroids in patients with allergic rhinitis or nasal polyposis. Methods We performed a systematic review and meta-analysis of randomized controlled trials of the effectiveness of Leukotriene Receptor antagonists in patients with rhinitis. Composite daily rhinitis symptom scores (as a percentage of the maximum score) and rhinitis-specific quality of life (unit scores ranging from 0 to 6) were pooled after assessing heterogeneity among studies. The pooled estimates were expressed as weighted mean differences between treatments in a random-effects model. We considered a difference of 10% in nasal score and 0.6 units in quality-of-life score to be clinically relevant. Results Of the 196 citations, 11 studies on seasonal allergic rhinitis were used in the analysis: eight evaluating Leukotriene Receptor antagonists alone or in combination with other treatments versus placebo or other treatments (n = 3924) and three evaluating Leukotriene Receptor antagonists plus an antihistamine (n = 80). Leukotriene Receptor antagonists reduced mean daily rhinitis symptom scores (in absolute terms) 5% (95% confidence interval [CI]: 3% to 7%) more than did placebo. However, antihistamines improved the nasal symptoms score 2% (95% CI: 0% to 4%) more than did Leukotriene Receptor antagonists, and nasal corticosteroids improved the score 12% (95% CI: 5% to 18%) more than did Leukotriene antagonists. Leukotriene Receptor antagonists significantly improved rhinoconjunctivitis quality of life by 0.3 units (95% CI: 0.24 to 0.36 units) when compared with placebo. There were no randomized controlled trials evaluating the effect of Leukotriene Receptor antagonists on perennial allergic rhinitis or polyposis. Conclusion Leukotriene Receptor antagonists are modestly better than placebo, as effective as antihistamines, but less effective than nasal corticosteroids in improving symptoms and quality of life in patients with seasonal allergic rhinitis.