Montelukast and improvement of eczema: observations from a prescription event monitoring study in England

Objective: Montelukast is an orally administered cysteinyl receptor antagon ist, approved for the treatment of asthma. There is pharmacological plausib ility of its effectiveness in the treatment of other immunologically mediat ed conditions such as eczema and urticaria. The objective of this study was to determine whether there are any beneficial effects of montelukast on ec zema and urticaria. Method: A non-interventional observational cohort study was conducted between February 1998 and December 1998 using Prescription-E vent Monitoring (PEM). During PEM studies, patients are systematically iden tified from dispensed prescription data and questionnaires are sent to the prescribing general practitioner (GP) asking them to report events occurrin g during and after treatment. In this study, events reported as eczema or u rticaria improved were identified. A simple questionnaire was sent to the G Ps for additional information. Results: The cohort comprised 15,612 patient s, in which 16 reports of eczema or urticaria improved were identified. Que stionnaires were sent to the GPs for additional information. Fifteen of the 16 questionnaires were returned. In 5 cases the GPs thought that there was an improvement of eczema or urticaria with montelukast treatment in patien ts who had history of longstanding eczema or urticaria. Of the remaining 11 cases there was an alternative explanation for the improvement of eczema o r urticaria in 10 cases and one was unassessable. Conclusion: PEM is conduc ted to monitor the safety of medicines, and doctors report events including improvement in pre-existing conditions. Although the number of cases of im provement of eczema or urticaria in this cohort is small, there is a possib ility that leukotriene inhibitors may be helpful in the treatment of these diseases. Further studies are needed to provide evidence as to whether mont elukast will have a role in the treatment of these conditions.