Many patients with
chronic idiopathic urticaria are not sufficiently controlled with
histamine H(1)-receptor antagonists.
Leukotriene receptor antagonists have been reported to be effective for certain cases of
urticaria, although their proper application remains to be established. To study the effectiveness of
montelukast, a
leukotriene receptor antagonist, for the treatment of
chronic urticaria that was not controlled by
histamine H(1)-receptor antagonists. Twenty-five patients with
chronic idiopathic urticaria were treated with 10 mg of
montelukast for one week or more, without changing any precedent treatment that they were using before the study including
histamine H(1)-receptor antagonists. The effectiveness of
montelukast for each patient was evaluated and compared with clinical features and/or backgrounds of the patients. Twelve patients, including six who had been treated with
corticosteroids, were evaluated as "markedly improved" or "improved" following treatment with
montelukast. There was no statistically significant relation of the effectiveness to the complications with non-steroidal anti-inflammatory drugs (
NSAIDs) intolerance, mechanical
urticaria, or reactions to autologous serum skin test. However, the patients for whom
montelukast was effective were younger (33.2+/-16.3 years, mean +/- SD)(P<0.05, Mann-Whitney test) and their duration of illness shorter (15.9+/-18.3 months) (P<0.005, Mann-Whitney test) than those of patients for whom
montelukast was ineffective (45.9+/-15.0 years, 89.6+/-71.7 months).
Montelukast may be worth trying for patients with
chronic idiopathic urticaria, when the condition is not sufficiently controlled with
histamine H(1)-receptor antagonists.