Marginal utility of montelukast for persistent asthma.

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 beta(2)-agonist therapy. CONCLUSION Montelukast had marginal utility in the management of these adult patients with controlled persistent asthma.