Trends in prescribing montelukast in patients with asthma in real-life: Results from the Turkish adult asthma registry
Authors: Beyaz Şengül , Erdinç Münevver , Hayme Serhat , Feyza Aslan Ayşe , Aydın Ömür , Gökmen Derya , Köycü Buhari Gözde , Çelebi Sözener Zeynep , Gemicioğlu Bilun , Bulut İsmet , Örçen Cihan , Kepil Özdemir Seçil , Keren Metin , Damadoğlu Ebru , Yakut Tuğçe , Füsun Kalpaklıoğlu Ayşe , Baccıoğlu Ayşe , Alan Yalım Sümeyra , Yılmaz İnsu , Koca Kalkan İlkay , Atilla Uysal Mehmet , Özgün Niksarlıoğlu Elif Yelda , Fuat Kalyoncu Ali , Karakaya Gül , Erbay Müge , Naycı Sibel , Merve Tepetam Fatma , Akkor Gelincik Aslı , Dirol Hülya , Göksel Özlem , Karaoğlanoğlu Selen , Öner Erkekol Ferda , Rana Isık Sacide , Yıldız Füsun , Yavuz Yasemin , Karadoğan Dilek , Bozkurt Nurgül , Şeker Ümmühan , Kıvılcım Oğuzülgen İpek , Başyiğit İlknur , Argun Barış Serap , Yılmazel Uçar Elif , Erdoğan Tuba , Polatlı Mehmet , Ediger Dane , Esra Günaydın Fatma , Türk Murat , Pür Leyla , Yeğin Katran Zeynep , Sekibağ Yonca , Furkan Aykaç Enes , Mungan Dilşad , Gül Özcan , Cengiz Ali , Akkurt Bülent , Özden Şeyma , Demir Semra , Ünal Derya , Can Ali , Gümüşburun Reyhan , Boğatekin Gülhan , Serpil Akten Hatice , İnan Sinem , Candan Öğüş Aliye , Kavas Murat , Polat Yuluğ Demet , Erdem Çakmak Mehmet , Buğra Kaya Saltuk , Alpagat Gülistan , Sercan Özgür Eylem , Uzun Oğuz , Taş Gülen Şule , Pekbak Gülseren , Kızılırmak Deniz , Havlucu Yavuz , Dönmez Halil , Arslan Bahar , Paçacı Çetin Gülden , Soyyiğit Şadan , Yılmaz Kara Bilge , Paşaoğlu Karakış Gülden , Berna Dursun Adile , Kendirlinan Reşat , Bilge Öztürk Ayşe , Sevinç Can , Ömeroğlu Şimşek Gökçen , Abadoğlu Öznur , Çerçi Pamir , Yücel Taşkın , Yorulmaz İrfan , Çiler Tezcaner Zahide , Çadallı Tatar Emel , Emre Süslü Ahmet , Özer Serdar , Dursun Engin , Yorgancıoğlu Arzu , Elif Çelik Gülfem 
Published: January 2025

Montelukast, a leukotriene receptor antagonist (LTRA) approved for the treatment of asthma and allergic rhinitis, is widely used, though real-world data on its application in asthma management remain limited. This registry-based study evaluated the use of montelukast in adult asthma patients, examining demographic and disease characteristics, asthma control status, asthma phenotypes, presence of atopy, and treatment regimens. Among 2053 patients analyzed, 61.76% (n = 1268; mean age: 46.2 ± 14.3 years), predominantly females (~76%), received montelukast. Montelukast users showed higher rates of allergic rhinitis (P < 0.001), hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (P = 0.008), and chronic rhinosinusitis (P = 0.008). Montelukast group also had higher atopy and total IgE levels and tended to be more eosinophilic. Montelukast was commonly preferred in allergic, eosinophilic, NSAID-exacerbated respiratory disease, and severe asthma phenotypes (P < 0.001). Patients receiving Steps 4 and 5 treatments are more likely to be prescribed montelukast (P < 0.001). Montelukast usage was higher among patients with uncontrolled asthma [ACT< 20 (OR:1.29, 95%CI:1.052–1.582, P = 0.014)]. In addition, logistic regression analyses identified the main factors associated with increased montelukast use as; female gender (OR:1.33, 95%CI:1.041–1.713, P = 0.02), presence of atopy (OR:1.46, 95%CI:1.157–1.864, P = 0.002), comorbid allergic rhinitis (OR:2.12, 95%CI:1.679–2.293, P < 0.001), and severe asthma (OR:2.18, 95%CI:1.712–2.784, P < 0.001). These findings reveal that montelukast use is prevalent among asthma patients, particularly in females, middle-aged adults, and those with comorbid allergic rhinitis, uncontrolled asthma, or specific asthma phenotypes, underscoring the factors that influence its prescription in asthma management.