[The effectiveness of leukotriene antagonists in the treatment of aspirin-intolerant asthmatic patients].

Introduction: The aim of this study was to assess the efficacy of leucotrien- antagonists in aspirin-intolerant asthma (AIA). The severity of asthma was evaluated according to GINA guidelines. On each consultation, the patients filled-in a simplified self-assessment questionnaire on rhinitis and quality of life (QOL).

Methods: Montelukast was administered during the inclusion visit. Patients' general state of health was assessed, FEV1 and MMEF25-75 were measured and the QOL and rhinitis scores and therapeutic impact were analysed at 3 and 6 months.

Results: Sixteen patients were included. FEV1 was initially recorded at 62% +/- 23 of theoretical values and then improved to 73% +/- 26.8 (p<0.002), and 77.2% +/- 17. Initial rhinitis score was 13 +/- 3.7 then 9 +/-5 (p<0.006) and 5.7 +/- 3.5 (p<0.03). Oral corticosteroids were required in 12 patients (8.5 +/- 5.6 mg). This dose was tapered to 3.4 +/- 6.4 mg (p<0.04) and 2.1 +/- 4.4 mg and stopped in 8 patients. The initial QOL score was of 4.36 +/- 1.4 and improved to 5.87 +/- 1.06 (p<0.002), and to 5.90 +/- 1.12.

Discussion: Aspirin-induced asthma is a challenging issue. Rhinitis is a major feature of discomfort. Following montelukast administration, we noted an improvement in the QOL and rhinitis subjective parameters, and an objective improvement in spirometrical measurements and in the doses of oral corticosteroids.

Conclusion: Early recognition of these asthmatic patients is required in order to optimise their management. Administration of montelukast could be envisaged as unofficial first-line therapy in these patients combined with the recommended treatments.