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Patil T, Raguindin JJ, Radtke M, Smigiel J, Savona N, Kavuru B, Sekhri A. Evaluating the Association of Montelukast Use on Neuropsychiatry-Related Healthcare Utilization and Depression in COVID-19-Hospitalized Veterans: A Nationwide VA Observational Cohort Study. Clin Drug Investig 2023; 43:605-619. [PMID: 37498493 DOI: 10.1007/s40261-023-01292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Montelukast's new boxed warning for neuropsychiatric events questions its use in the setting of coronavirus disease 2019 (COVID-19) due to increased risk for new-onset psychiatric diagnoses. OBJECTIVE We aim to evaluate the impact of using montelukast in patients hospitalized with COVID-19 on neuropsychiatry-related healthcare utilization and depression. METHODS This retrospective nationwide observational cohort study using the Veterans Health Administration database included patients from January 1, 2020, through July 1, 2021. The treatment cohorts consisted of patients with and without montelukast use prior to COVID-19 hospitalization and matched using propensity score (PS) to two control cohorts: patients with COVID-19-related hospitalization without prior montelukast use and patients with prior montelukast use who were hospitalized for reasons other than COVID-19. The primary outcome of psychiatric hospitalizations at 90 days and 180 days and mental health visits at 180 days were compared using Poisson or negative binomial regression. Secondary outcomes of new-onset depression and new use of antidepressants were analyzed using multivariable logistic regression. RESULTS After PS matching, a total of 415 patients were included in COVID-19 with and without montelukast matched cohort and 409 patients in montelukast with and without COVID-19-related hospitalization matched cohorts. For the primary outcomes, inpatient psychiatric hospitalization at 90 days [incidence rate ratio (IRR) 95% CI 1.79 (1.36-2.36)] and 180 days [IRR 95% CI 1.79 (1.32-2.25)] and mental health visits at 180 days [IRR 95% CI 1.72 (1.45-2.03)] were significantly higher in the montelukast with COVID-19 hospitalization group compared with those hospitalized without COVID-19. No difference in primary outcomes were noted in patients hospitalized with COVID-19 with and without use of montelukast. No significant difference was found in the secondary outcomes between either comparator group. CONCLUSIONS Patients with prior montelukast use who were hospitalized with COVID-19 appeared to have increased rate of neuropsychiatry-related healthcare utilization.
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Affiliation(s)
- Tanvi Patil
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA.
| | - Jasper Jade Raguindin
- Central Western Massachusetts Veterans Affair Health Care System, 421 N Main St, Leeds, MA, 01053, USA
| | - Michelle Radtke
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Joseph Smigiel
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Natalie Savona
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Bush Kavuru
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Anuradha Sekhri
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
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Xu C, Zhao H, Song Y, Zhou J, Wu T, Qiu J, Wang J, Song X, Sun Y. The Association between Allergic Rhinitis and COVID-19: A Systematic Review and Meta-Analysis. Int J Clin Pract 2022; 2022:6510332. [PMID: 36249911 PMCID: PMC9534623 DOI: 10.1155/2022/6510332] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/06/2022] [Accepted: 09/12/2022] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Previous studies have yielded conflicting results regarding the association of coronavirus disease 2019 (COVID-19) with allergic rhinitis (AR). Data on AR prevalence in COVID-19 patients are limited. Consequently, whether AR is a harmful or protective factor for COVID-19 patients remains controversial. Therefore, we analyzed the relationship between COVID-19 and AR. METHODS We systematically searched PubMed, Embase, Cochrane, and Web of Science databases for studies published between January 1, 2020 and January 11, 2022. We included studies reporting the epidemiological and clinical characteristics of COVID-19 and its incidence in patients with AR. We excluded letters, case reports, literature review articles, non-English language article, and non-full-text articles. The raw data from these studies were pooled into a meta-analysis. RESULTS We analyzed the results of nine studies. The prevalence of AR in patients with COVID-19 was 0.13 (95% confidence interval [CI] 0.04-0.25), with an overall I 2 of 99.77%, P=0.24. COVID-19 patients with AR are less prone to severe disease (odds ratio [OR] = 0.79, 95% CI, 0.52-1.18, P=0.25) and hospitalization (OR = 0.23, 95%CI, 0.02-2.67, P ≤ 0.0001) than patients without AR. CONCLUSION Our data suggest that allergic rhinitis is a protective factor in patients with COVID-19.
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Affiliation(s)
- Cong Xu
- The 2nd Medical College of Binzhou Medical University, Yantai 264000, Shandong, China
- Department of Otorhinolaryngology and Head and Neck Surgery, Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264000, Shandong, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
| | - He Zhao
- The 2nd Medical College of Binzhou Medical University, Yantai 264000, Shandong, China
- Department of Otorhinolaryngology and Head and Neck Surgery, Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264000, Shandong, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
| | - Yuwan Song
- Department of Otorhinolaryngology and Head and Neck Surgery, Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264000, Shandong, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
| | - Jiamin Zhou
- Department of Otorhinolaryngology and Head and Neck Surgery, Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264000, Shandong, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
| | - Ting Wu
- Department of Otorhinolaryngology and Head and Neck Surgery, Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264000, Shandong, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
| | - Jingjing Qiu
- Department of Otorhinolaryngology and Head and Neck Surgery, Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264000, Shandong, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
| | - Junxin Wang
- Department of Otorhinolaryngology and Head and Neck Surgery, Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264000, Shandong, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
- Weifang Medical University, Weifang, Shandong, China
| | - Xicheng Song
- Department of Otorhinolaryngology and Head and Neck Surgery, Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264000, Shandong, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
| | - Yan Sun
- Department of Otorhinolaryngology and Head and Neck Surgery, Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264000, Shandong, China
- Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai 264000, Shandong, China
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Dey M, Singh RK. Possible Therapeutic Potential of Cysteinyl Leukotriene Receptor Antagonist Montelukast in Treatment of SARS-CoV-2-Induced COVID-19. Pharmacology 2021; 106:469-476. [PMID: 34350893 DOI: 10.1159/000518359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 07/04/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The coronavirus disease-19 (COVID-19) pandemic is a serious devastating disease and has posed a global health emergency. So far, there is not any specific therapy approved till date to control the clinical symptoms of the disease. Remdesivir has been approved by the FDA as an emergency clinical therapy. But it may not be effective alone to control the disease as it can only control the viral replication in the host. SUMMARY This article summarizes the possible therapeutic potential and benefits of using montelukast, a cysteinyl leukotriene 1 (CysLT1) receptor antagonist, to control COVID-19 pathophysiology. Montelukast has shown anti-inflammatory effects, reduced cytokine production, improvement in post-infection cough production and other lung complications. Key Messages: Recent reports clearly indicate a distinct role of CysLT-regulated cytokines and immunological signaling in COVID-19. Thus, montelukast may have a clinical potential to control lung pathology during COVID-19.
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Affiliation(s)
- Mangaldeep Dey
- National Institute of Pharmaceutical Education and Research, Department of Pharmacology and Toxicology, Raebareli, Transit campus, Lucknow, India
| | - Rakesh Kumar Singh
- National Institute of Pharmaceutical Education and Research, Department of Pharmacology and Toxicology, Raebareli, Transit campus, Lucknow, India
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Duan XJ, Zhang X, Li LR, Zhang JY, Chen YP. MiR-200a and miR-200b restrain inflammation by targeting ORMDL3 to regulate the ERK/MMP-9 pathway in asthma. Exp Lung Res 2020; 46:321-331. [PMID: 32820688 DOI: 10.1080/01902148.2020.1778816] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Asthma is one of the most frequent and serious diseases worldwide. Inflammation has been reported to correlate with airway remodeling, which is critical for the progression of asthma. Better understanding of novel molecules modulating asthma and the underlying mechanism will benefit explorations of new treatments. Method: To explore the role of miR-200a and miR-200b in asthma, miR-200a mimics/inhibitor and miR-200b mimics/inhibitor were employed in A549 cells, respectively. Expression levels of inflammatory cytokines, including TNF-α, IL-4, IL-5, IL-13 and IL-1β, were measured by quantitative real time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA). A dual luciferase reporter assay was performed to identify whether miR-200a/200b directly bound to Orosomucoid 1-like 3 (ORMDL3). ERK, p-ERK and MMP-9, involved in downstream pathways of ORMDL3, were detected using qRT-PCR and western blotting. Results: MiR-200a/200b silencing significantly increased the expression of inflammatory cytokines, including TNF-α, IL-4, IL-5, IL-13 and IL-1β, in A549 cells. ORMDL3 was the target gene of miR-200a/200b, with high expression levels in miR-200a inhibitor and miR-200b inhibitor groups. MiR-200a and miR-200b played synergistic roles in the regulation of the inflammatory effect in A549 cells. Expression levels of p-ERK and MMP-9 were significantly increased in miR-200a inhibitor and miR-200b inhibitor groups and were rescued by ERK inhibitor and MMP-9 inhibitor, respectively. Conclusion: These findings suggest that miR-200a and miR-200b are required to regulate asthma inflammation. Reduction in miR-200a/200b promotes the development of asthma inflammation by targeting ORMDL3 to activate the ERK/MMP-9 pathway. Therefore, elevating miR-200a and miR-200b and decreasing ORMDL3 might be potential strategies for inhibition of the asthma process.
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Affiliation(s)
- Xiao-Jun Duan
- The Second Department of Respiratory, Hunan Children's Hospital, Changsha, P. R. China
| | - Xi Zhang
- The Second Department of Respiratory, Hunan Children's Hospital, Changsha, P. R. China
| | - Lin-Rui Li
- The Second Department of Respiratory, Hunan Children's Hospital, Changsha, P. R. China
| | - Ji-Yan Zhang
- The Second Department of Respiratory, Hunan Children's Hospital, Changsha, P. R. China
| | - Yan-Ping Chen
- The Second Department of Respiratory, Hunan Children's Hospital, Changsha, P. R. China
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Ikram A, Kumar V, Taimur M, Khan MA, Fareed S, Barry HD. Role of Montelukast in Improving Quality of Life in Patients with Persistent Asthma. Cureus 2019; 11:e5046. [PMID: 31501737 PMCID: PMC6721874 DOI: 10.7759/cureus.5046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Maintenance therapy of asthma has a crucial role in keeping the disease dormant and preventing frequent acute exacerbations. Asthma control may be achieved by inhaled corticosteroids (ICS) and/or long-acting beta-agonists (LABA). Leukotriene receptor antagonist - montelukast - may be added as an add-on to ICS/LABA or may also be given in monotherapy. The aim of this study was to evaluate the role of montelukast monotherapy as asthma control and its impact on the quality of life of these patients. Methods In this prospective, open-label, interventional study, montelukast 10 mg once daily was given to patients with mild to moderate persistent asthma for four weeks. Quality of life (QOL) was assessed on the Asthma Quality of Life Questionnaire - Standard (AQLQ-S) questionnaire. Asthma control was assessed on the Asthma Control Test (ACT). Data was entered and analyzed using SPSS version 23.0. Results On AQLQ-S, overall QOL improved with one month of montelukast therapy significantly. On sub-scales, except for emotional function, all other three sub-scales including symptoms, activity limitation, and environmental function improved significantly. Asthma control score also significantly improved with one month of montelukast therapy. Conclusion Montelukast has an effective role in asthma control and improvement of QOL in patients with mild to moderate persistent asthma.
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Affiliation(s)
- Ayesha Ikram
- Internal Medicine, King Edward Medical University/Mayo Hospital, Lahore, PAK
| | - Vinod Kumar
- Hospital Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, ARE
| | - Muhammad Taimur
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Mahrukh A Khan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Sundus Fareed
- Internal Medicine, Civil Hospital Karachi, Karachi, PAK
| | - Habiba D Barry
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
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Köse E, Oğuz F, Vardi N, Ediz Sarihan M, Beytur A, Yücel A, Polat A, Eki Nci N. Therapeutic and protective effects of montelukast against doxorubicin-induced acute kidney damage in rats. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2019; 22:407-411. [PMID: 31168345 PMCID: PMC6535195 DOI: 10.22038/ijbms.2019.33493.7996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective(s): The current study was designed to investigate the therapeutic and protective effects of montelukast (ML) against doxorubicin (DOX)-induced acute kidney damage in rats. Materials and Methods: Thirty-five Wistar albino female rats were randomly divided into 5 groups as follows: Group I: Control; Group II: Control+ML; Group III: DOX; Group IV: DOX+ML; Group V: ML+DOX. At the end of the experiment, the kidney tissues of rats were collected. Thiobarbituric acid reactive substance (TBARS), reduced glutathione, superoxide dismutase (SOD), and catalase levels were determined from the kidney tissues. In addition, the kidney tissues were examined histologically. Results: DOX induced a significant increase in the kidney TBARS levels, whereas SOD contents significantly decreased when compared with the control group. On the other hand, ML administration before and after DOX injection caused significant decreases in TBARS production and also increases in SOD levels. Histologically, the most remarkable damage was glomerulosclerosis and tubular changes in the DOX group. Moreover, marked tubular necrosis and swelling in tubular epithelial cells were observed in this group. Contrarily, although glomerulosclerosis was recognized as alleviated also in both DOX+ML and ML+DOX groups, the lesions did not completely ameliorate. However, treatment with ML after DOX injection was more effective than treatment with ML before DOX injection with respect to the protection of tubular structures. Conclusion: It was determined that ML treatment after DOX injection caused therapeutic effects against DOX-induced kidney damage. Thence, ML treatment is of some clinical properties for oxidative stress damage in kidney tissues.
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Affiliation(s)
- Evren Köse
- Department of Anatomy, School of Medicine, Inonu University, Malatya, Turkey
| | - Fatih Oğuz
- Department of Urology, School of Medicine, Inonu University, Malatya, Turkey
| | - Nigar Vardi
- Department of Histology-Embryology, School of Medicine, Inonu University, Malatya, Turkey
| | - Mehmet Ediz Sarihan
- Department of Emergency, School of Medicine, Inonu University, Malatya, Turkey
| | - Ali Beytur
- Department of Urology, School of Medicine, Inonu University, Malatya, Turkey
| | - Aytaç Yücel
- Department of Anesthesiology and Reanimation, School of Medicine, Inonu University, Malatya, Turkey
| | - Alaadin Polat
- Department of Physiology, School of Medicine, Inonu University, Malatya, Turkey
| | - Nihat Eki Nci
- Department of Anatomy, School of Medicine, Erciyes University, Kayseri, Turkey
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