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Montelukast use in atopic dermatitis has been evaluated in many clinical trials. It affects the clinical severity scores and some inflammatory markers. Aim of this study was to evaluate the drug-saving effect and analyze the cost of montelukast therapy on oral antihistamines and topical steroids in children with moderately severe atopic dermatitis. Randomized, double-blind, placebo-controlled, crossover trial with washout period, conducted from May 2002 to February 2006. The study involved 25 patients, 2-16 years old with dermatitis. Patients received oral montelukast (9 patients, Group B) or placebo (16 patients, Group A) in phase 1, and were crossed over to placebo or montelukast, respectively, for phase 2. Patients included if >10% of skin was involved and failed response to 2 week conventional treatment. At each of 2-week clinic visits, the amount of medication used was measured and cost calculated for oral antihistamines, topical steroids, and oral antibiotics. During montelukast use, the amounts of oral histamines, or topical steroids, or oral antibiotic courses were not significantly different from their counterparts during placebo use. It did not reduce the medications cost. However, montelukast increased the direct medication cost by 138%. In children with moderately severe atopic dermatitis, montelukast does not have any drug-sparing effect on oral antihistamines or topical steroid amounts. It increased the direct treatment cost of this disease.
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Author(s): Mohammad S Ehlayel and Abdulbari Bener
Montelukast. Children. Moderate. Severe. Atopic Dermatitis