Prophylactic Treatment with Montelukast on Japanese Cedar Pollinosis

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  • モンテルカストのスギ花粉症に対する初期療法の検討

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Montelukast, a leukotriene receptor antagonist (LTRA), was orally administered at 10mg once daily to prophylactically treat 86 subjects with Japanese cedar pollionosis between January and March (4289 cedar grains/cm2). Of these 35 (40.7%), tolerated seasonal nasal symptoms well with montelukast alone. Of the remaining 51 reporting worsened seasonal nasal symptoms with montelukast alone, 17 were prescribed an antihistamine and/or corticosteroid nasal spray in addition to montelukast and 17 had montelukast replaced by the nasal spray.<br>The initial dates on which, 48 of 51 reported that montelukast alone was insufficient to control symptoms were noted. Of these 48, 22 had initial dates preceding February 13 and were considered nonresponders to LTRA, because LTRA did not control their allergic reactions despite low pollen exposure. A further 24 stopped montelukast treatment at the first peak pollen exposure on February 16, and 2 more were added to dropouts at the second pollen exposure peak on March 1. These results suggest that those whose nasal symptoms were controlled prophylactically until the early pollen exposure peak day do not require additional medication for the rest of the pollen season.

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