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All Studies   Meta Analysis    Recent:   

Effect of montelukast therapy on clinical course, pulmonary function, and mortality in patients with COVID‐19

Kerget et al., Journal of Medical Virology, doi:10.1002/jmv.27552, NCT05094596
Jan 2022  
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Mortality 92% Improvement Relative Risk Mortality, 20mg 89% Mortality, 10mg 89% MAS or respiratory failure 81% MAS or respiratory failure.. 88% MAS or respiratory fail.. (b) 75% Hospitalization time, 20mg 15% Hospitalization time, 10mg 15% Montelukast  Kerget et al.  LATE TREATMENT  RCT Is late treatment with montelukast beneficial for COVID-19? RCT 180 patients in Turkey (May - July 2021) Lower mortality (p=0.012) and progression (p=0.0071) c19early.org Kerget et al., J. Medical Virology, Jan 2022 Favorsmontelukast Favorscontrol 0 0.5 1 1.5 2+
28th treatment shown to reduce risk in November 2021
 
*, now with p = 0.0045 from 8 studies.
Lower risk for mortality, hospitalization, and cases.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 77 treatments. c19early.org
RCT 180 hospitalized COVID-19 patients in Turkey showing faster reduction in inflammatory markers, improved pulmonary function, and lower rates of macrophage activation syndrome, respiratory failure and mortality with montelukast treatment (10mg or 20mg daily) in addition to standard care. The higher dose of 20mg daily showed greater improvement in pulmonary function compared to 10mg daily. There was no mortality in the montelukast groups compared to 6.7% mortality with standard care alone.
risk of death, 92.3% lower, RR 0.08, p = 0.01, treatment 0 of 120 (0.0%), control 4 of 60 (6.7%), NNT 15, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of death, 88.9% lower, RR 0.11, p = 0.12, treatment 0 of 60 (0.0%), control 4 of 60 (6.7%), NNT 15, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), 20mg.
risk of death, 88.9% lower, RR 0.11, p = 0.12, treatment 0 of 60 (0.0%), control 4 of 60 (6.7%), NNT 15, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), 10mg.
MAS or respiratory failure, 81.2% lower, RR 0.19, p = 0.007, treatment 3 of 120 (2.5%), control 8 of 60 (13.3%), NNT 9.2.
MAS or respiratory failure, 87.5% lower, RR 0.12, p = 0.03, treatment 1 of 60 (1.7%), control 8 of 60 (13.3%), NNT 8.6, 20mg.
MAS or respiratory failure, 75.0% lower, RR 0.25, p = 0.09, treatment 2 of 60 (3.3%), control 8 of 60 (13.3%), NNT 10.0, 10mg.
hospitalization time, 15.5% lower, relative time 0.85, p = 0.04, treatment mean 9.3 (±3.6) n=60, control mean 11.0 (±5.3) n=60, 20mg.
hospitalization time, 14.5% lower, relative time 0.85, p = 0.03, treatment mean 9.4 (±2.1) n=60, control mean 11.0 (±5.3) n=60, 10mg.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kerget et al., 4 Jan 2022, Randomized Controlled Trial, Turkey, peer-reviewed, mean age 54.6, 4 authors, study period May 2021 - July 2021, trial NCT05094596 (history). Contact: bjkerget1903@gmail.com.
This PaperMontelukastAll
Effect of montelukast therapy on clinical course, pulmonary function, and mortality in patients with COVID‐19
Buğra Kerget, Ferhan Kerget, Murat Aydın, Ömer Karaşahin
Journal of Medical Virology, doi:10.1002/jmv.27552
The inflammatory/anti-inflammatory balance has an important role in the clinical course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) infection, which has affected over 200 million people since it first appeared in China in December 2019. This study aimed to determine the effectiveness of montelukast, which has known anti-inflammatory and bronchodilatory effects, in these patients. The prospective randomized controlled study included 180 patients who were hospitalized in the infectious diseases department of our hospital between May and July 2021 and were diagnosed with the delta variant of SARS-CoV-2 by real-time polymerase chain reaction of nasopharyngeal swabs. The patients were divided into three groups and received only standard treatment according to national guidelines (Group 1) or standard treatment plus 10 mg/day montelukast (Group 2) or 20 mg/day montelukast (Group 3). Laboratory parameters and pulmonary function tests (PFTs) at admission and on Day 5 of treatment were compared. Comparison of laboratory parameters on Day 5 showed that Groups 2 and 3 had significantly lower levels of lactate dehydrogenase, fibrinogen, D-dimer, C-reactive protein, and procalcitonin compared with Group 1 (p = 0.04, 0.002, 0.05, 0.03, and 0.04, respectively). In the comparison between Groups 2 and 3, only fibrinogen was significantly lower in Group 3 (p = 0.02). PFT results did not differ between the groups at admission, while on Day 5, only Group 3 showed significant improvements in forced expiratory volume in 1 s, forced vital capacity, and peak expiratory flow 25-75 compared with admission (p = 0.001 for all). Montelukast may be beneficial in COVID-19 patients to maintain the inflammatory/anti-inflammatory balance, prevent respiratory failure through its bronchodilator activity, and reduce mortality.
T A B L E 3 Regression analysis of laboratory and pulmonary function parameters in Group 2 (10 mg montelukast) and Group 3 (20 mg montelukast) CONFLICT OF INTERESTS The authors declare that there are no conflict of interests. AUTHOR CONTRIBUTIONS
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Late treatment
is less effective
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