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【medical-news】孟鲁司特与Churg-Strauss综合征有关，
By Scott Baltic
NEW YORK (Reuters Health) Aug 07 - Although use of the leukotriene receptor antagonist montelukast is associated with a significant risk of Churg-Strauss syndrome (CSS), it is likely "a proxy measure for gradually worsening asthma at an individual level and for the important increase in montelukast exposure in general," researchers conclude in a study published in the August issue of Thorax.
"According to the findings of our study ... we think that Singulair (montelukast) does not trigger or cause Churg-Strauss syndrome," Dr. Alfred Mahr told Reuters Health. "We rather believe that the fact that many people take this drug before developing Churg-Strauss syndrome is explained by the bad asthma, the phenomenon of 'confounding'."
CSS is an autoimmune small-vessel vasculitis of unknown etiology that occurs in the context of asthma and eosinophilia.
The retrospective study by Dr. Mahr of the Hopital Cochin, Paris, and colleagues involved 78 participants recruited from the French Vasculitis Study Group and the Interdisciplinary Vasculitis Center, Bad Bramstedt, Germany. The great majority of them met the American College of Rheumatology criteria for CSS.
Through reviews of hospital records and interviews with the patients, their physicians and their pharmacists, the researchers created a record for each patient of all asthma medication he or she had taken in the 24 months before being diagnosed with CSS.
Based on the assumption that the onset of CSS would occur within 3 months of the first exposure to montelukast or another pharmaceutical trigger, the researchers designated the 3-month period immediately prior to diagnosis of CSS as the "index" period. The 4 consecutive 3-month periods prior to that were considered the "control" periods.
Twenty subjects had been exposed to montelukast during that 15-month period.
Treatment with montelukast was found to be associated with an odds ratio of 4.5 for developing CSS within 3 months. However, all the other therapies analyzed also had positive odds ratios: 3.0 for inhaled long-acting beta-2 agonists, 1.7 for inhaled corticosteroids and 4.0 for oral corticosteroids.
The investigators also found that there was a statistically significant increase over time, from July 1999 to December 2003, in exposure to montelukast (p < 0.0001).
Summing up, Dr. Mahr said, "This study implies that physicians should likely not be reluctant to prescribe Singulair (montelukast), and by analogy possibly also the other agents of this drug class, because of fear of Churg-Strauss syndrome."
Thorax 2008;63:677-682.
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作者:admin@医学,生命科学 2010-10-06 17:11
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