Open-label Study of the Effects of Montelukast in Patients With Chronic Cough
Condition: Coughing
MeSH terms: Cough
Study type: Interventional
Phase: Phase 4

Summary: 
      Montelukast, a leukotriene receptor antagonist, is likely to be effective in the treatment of
      chronic cough and this could be made objective by measuring cough threshold before and after
      two weeks of treatment.
    

Detailed description: 
      Chronic cough is typically defined as cough that persists for longer than 8 weeks and is the
      most common presenting symptom in adults who seek medical treatment in an ambulatory setting.
      Prospective studies have shown that three conditions account for the etiologic cause of
      chronic cough in the largest part of immunocompetent, nonsmoking patients with normal chest
      radiograph findings. In order of frequency, they are upper airway cough syndrome (UACS),
      previously referred to as postnasal drip syndrome (PNDS), asthma and gastroesophageal reflux
      disease (GERD). UACS comprises many different conditions including PNDS, acute sinusitis,
      allergic rhinitis, non-allergic rhinitis (postinfectious rhinitis, rhinitis medicamentosa,
      vasomotor rhinitis, rhinitis due to physical or chemical irritants). Cough occurs in all
      asthmatics, and in a subset of patients with cough-variant asthma (CVA), it is the only
      presenting symptom. In these cases it is well controlled with inhaled corticosteroids and
      beta-2 agonists. GERD is another cause that should be contemplated when anti-tussive or
      anti-inflammatory/anti-allergic treatment do not render results and when there are presenting
      symptoms suggestive of it. Moreover, factors like smoking and use of ACE-inhibitors should
      also be taken into account.

      Leukotrienes are very important agents in the inflammatory response. It is known that they
      are contributing significantly to the pathological processes in asthma. Montelukast is a
      leukotriene receptor antagonist which blocks the bonding of leukotrienes to their receptors
      thus inhibiting their inflammatory, bronchoconstrictive and mucosecretory effects. Multiple
      clinical trials have demonstrated the ability of the leukotriene antagonists to improve
      symptoms, pulmonary function and bronchial hyperresponsiveness in patients with asthma.
      However, not much is known about their effects in people with chronic cough. Studies have
      been carried out in an attempt to find out the effects of montelukast in some forms of
      chronic cough. Nevertheless, the impact of montelukast on objective parameters such as cough
      reflex threshold, has not been explored. The investigators also reckon that montelukast will
      affect exhaled breath temperature - a novel surrogate marker of airway inflammation
      recognized lately
    

Intervention name(s): Montelukast
Intervention type(s): Drug
Intervention description(s): Montelukast is a leukotriene receptor antagonist
Other intervention name(s): Alvokast
Intervention MeSH terms: Montelukast
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment