Overview
Oral steroid-dependent asthma is a severe form of asthma requiring systemic corticosteroid therapy for control. Management aims to reduce reliance on oral steroids while maintaining asthma control and preventing exacerbations.Diagnosis
No information provided in the abstracts.Management
Montelukast, when added to standard asthma attack treatment in children, showed no added benefit in controlling asthma attack severity, oxygen saturation, length of hospitalization, or intensive care unit admissions 2.
Withdrawal of montelukast in children and young people with asthma did not result in significant differences in lung function, fractional exhaled nitric oxide, or other asthma control measures compared to placebo 3.Special Populations
Pediatrics: Montelukast has been studied in children aged 1-14 years for asthma attacks 2 and in children and young people (0-18 years) for withdrawal from therapy 3.Key Recommendations
Montelukast does not appear to provide added benefit when used alongside standard treatment for acute asthma attacks in children 2. (Evidence: Strong)
Withdrawal of montelukast in children and young people with asthma did not lead to significant changes in lung function or other asthma control outcomes 3. (Evidence: Moderate)
Vitamin D may modulate inhaled corticosteroid (ICS) response through miRNAs involved in immune cell differentiation, potentially serving as biomarkers for ICS response, especially in vitamin D insufficient individuals 1. (Evidence: Weak)References
1 Jiang M, Zhang Y, Liu T, Hong X, Kho AT, Li J et al.. Circulating miRNAs and childhood asthma ICS response: a stratified analysis in the intervention arm of an RCT with vitamin D effect modification. Thorax 2025. link
2 Jafari M, Sobhani M, Eftekhari K, Malekiantaghi A, Gharagozlou M, Shafiei A. The Effect of Oral Montelukast in Controlling Asthma Attacks in Children: A Randomized Double-blind Placebo Control Study. Iranian journal of allergy, asthma, and immunology 2023. link
3 Dixon EG, King C, Lilley A, Sinha IP, Hawcutt DB. Deprescribing montelukast in children with asthma: a systematic review. BMJ open 2022. link