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Table of Contents
Vol. 144, No. 2, 2007
Issue release date: September 2007
Section title: Original Paper
Int Arch Allergy Immunol 2007;144:137–142
(DOI:10.1159/000103225)

Premedication with Montelukast Reduces Local Reactions of Allergen Immunotherapy

Wöhrl S.a · Gamper S.b · Hemmer W.d · Heinze G.c · Stingl G.a · Kinaciyan T.a
Divisions of aImmunology, Allergy and Infectious Diseases (DIAID) and bGeneral Dermatology, Department of Dermatology, cSection of Clinical Biometrics, Core Unit for Medical Statistics and Informatics, Medical University of Vienna (MUW) and dFAZ – Floridsdorf Allergy Centre, Vienna, Austria

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 15, 2006
Accepted: February 20, 2007
Published online: May 25, 2007
Issue release date: September 2007

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 1018-2438 (Print)
eISSN: 1423-0097 (Online)

For additional information: http://www.karger.com/IAA

Abstract

Background: Local reactions (LRs) are a very frequent side effect of specific immunotherapy with allergens and can impair patients’ adherence. Antihistamine pretreatment – originally introduced as a safety measure to reduce anaphylactic side effects – has been the only treatment option for LRs so far, although these swellings usually do not appear immediately but after hours. We were interested whether pretreatment with the leukotriene antagonist montelukast would be better suited for preventing those reactions than pretreatment with the antihistamine desloratadine. Methods: Fifteen patients with a history of severe anaphylactic reactions to hymenoptera stings were enrolled into a prospective, double-blind, randomized, placebo-controlled pilot study. We selected a rush immunotherapy protocol consisting of 19 injections of hymenoptera venom administered over 5 consecutive days, where the majority is developing LRs, and counted the number of injections until an LR of >3 cm occurred. The patients were randomized to 3 treatment groups: premedication with placebo, 10 mg montelukast and 5 mg of the antihistamine desloratadine. Results: Compared with placebo, the occurrence of LRs (>3 cm) was significantly delayed by montelukast (p < 0.01, analysis of variance) but not by desloratadine (p = 0.19). The difference between montelukast and desloratadine was close to significant (p = 0.054). Itching, recorded on a scale from 0 to 5, did not differ between the 3 groups. Conclusion: Montelukast can be useful in the prevention of LRs after specific immunotherapy.

© 2007 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: August 15, 2006
Accepted: February 20, 2007
Published online: May 25, 2007
Issue release date: September 2007

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 1018-2438 (Print)
eISSN: 1423-0097 (Online)

For additional information: http://www.karger.com/IAA


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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