Evidence map›Paper›PMID 22029858›Full record

Trial reportThe Journal of asthma : official journal of the Association for the Care of Asthma2011

Risk factors for montelukast treatment failure in step-down therapy for controlled asthma.

M Bradley Drummond, Stephen P Peters, Mario Castro, Janet T Holbrook, Charles G Irvin, Lewis J Smith, Robert A Wise, Elizabeth A Sugar, American Lung Association Asthma Clinical Research Center Research Group

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in The Journal of asthma : official journal of the Association for the Care of Asthma, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. A prediction model for asthma exacerbations after stopping asthma biologics.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

M Bradley DrummondDivision of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. mdrummo3@jhmi.edu
Stephen P Peters
Mario Castro
Janet T Holbrook
Charles G Irvin
Lewis J Smith
Robert A Wise
Elizabeth A Sugar
American Lung Association Asthma Clinical Research Center Research Group
Johns Hopkins Medicine · USNorthwestern University · USWashington University in St. Louis · US

Funding

Mechanisms of COPD Subphenotype DevelopmentK23HL103192 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI DRUMMOND, MICHAEL BRADLEY · 2010 to 2013
$650k
NHLBI NIH HHS K23 HL103192
6 · The paper itself

Abstract

backgroundLeukotriene receptor antagonists including montelukast are an option for step-down therapy for mild asthmatics controlled on low-dose inhaled corticosteroids (ICS). Because some patients fail montelukast step-down therapy, it would be helpful for clinicians to be able to predict the risk of treatment failure.

objectivesTo determine patient characteristics associated with montelukast treatment failure and develop a clinical index to predict the risk of montelukast treatment failure.

methodsUsing the 165 participants in the Leukotriene or Corticosteroid or Corticosteroid-Salmeterol Study (LOCCS) trial who were stepped down from low-dose ICS to montelukast, we determined associations between enrollment variables and treatment failure. We constructed a montelukast failure index to predict the risk of montelukast treatment failure during step-down. To assess its specificity for montelukast, index performance was evaluated in the other LOCCS treatment groups.

resultsCharacteristics independently associated with montelukast treatment failure included age of asthma onset <10 years old (OR = 2.39; 95% CI = 1.17-5.02; p = .018), need for steroid burst in the last year (OR = 2.39; 95% CI = 1.13-5.09; p = .022), and pre-bronchodilator forced expiratory volume in 1 s (FEV(1)) (OR = 1.44 per 10% lower % predicted; 95% CI = 1.07-1.97; p = .016). A montelukast failure index was generated from these three variables (range: -5 to 7 points). Scores <0 predicted low risk (<0.20) of treatment failure, whereas scores >5 predicted high risk (>0.60) of treatment failure.

conclusionEarly asthma onset, worse asthma control in the last year, and lower pre-bronchodilator FEV(1) are associated with montelukast treatment failure. A montelukast failure index is proposed to quantify the risk of failure prior to treatment initiation.

Indexed as

AcetatesAdministration, InhalationAge of OnsetAnti-Asthmatic AgentsAsthmaCyclopropanesDouble-Blind MethodForced Expiratory VolumeGlucocorticoidsHumansLogistic ModelsQuinolinesRisk FactorsSensitivity and SpecificitySulfidesTreatment FailureAcetatesAnti-Asthmatic AgentsCyclopropanesGlucocorticoidsmontelukastQuinolinesSulfides

Identifiers

PMID22029858
PMCPMC4277696
OpenAlexW1984862045

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.