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Submitted: 07 Aug 2023
Accepted: 09 Nov 2023
ePublished: 29 Jan 2024
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J Nephropharmacol. 2024;13(2): e11650.
doi: 10.34172/npj.2023.11650
  Abstract View: 389
  PDF Download: 48

Clinical Trial

Evaluation of the effect of montelukast drug in improving the clinical condition of patients with COVID-19 in referral hospitals in Isfahan; a randomized clinical trial

Morteza Pourahmad 1 ORCID logo, Amir Aria 2 ORCID logo, Mahnaz Momenzadeh 3* ORCID logo, Fatemeh Nikoukar 1, Behrooz Ataei 4, Farzin Khorvash 1 ORCID logo, Manizhe Shams 5, Kiana Shahzamani 6 ORCID logo, Sara Nasirharandi 7

1 Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Internal Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
3 Department of Clinical Pharmacy and Pharmacy Practice, Isfahan University of Medical Sciences, Isfahan, Iran
4 Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
5 Disease Control Ward, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
6 Hepatitis Research Center, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
7 Department of Infectious Diseases, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
*Corresponding Author: Mahnaz Momenzadeh, Email: Mahnazmomenzadehf@gmail.com

Abstract

Introduction: COVID-19 is associated with a cascade of inflammatory responses potentially lead to devastating outcomes.

Objectives: The current study aims to investigate the efficacy of montelukast, a leukotriene receptor antagonist (LTRA), on laboratory parameters in COVID-19 infection.

Patients and Methods: The current randomized clinical trial (RCT) conducted on 67 patients with moderate-to-severe COVID-19 pneumonia in 2020-2021. All patients received treatments according to the national guidelines, while the case group additionally applied 10 mg montelukast for 14 days. The clinical disease improvement and laboratory data (complete blood cells count and differentiation, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), D-dimer, blood urea nitrogen (BUN), creatinine (Cr), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) were assessed within two weeks after the infection and compared between the groups.

Results: Baseline assessed parameters did not differ between the groups (P>0.05). A significant decrease in pulse rate, also in normal ranges, was notified in the montelukast-treated group compared with the baseline (P=0.001) and with controls (P=0.033); however, other vital signs were not statistically different (P>0.05). CRP (P<0.001), ESR (P=0.008), BUN (P=0.015), and AST (P<0.001) significantly decreased in the post-intervention assessment of the montelukast-treated group. The comparison of the groups in post-intervention reviews revealed significantly lower CRP (P=0.042) and D-dimer (P=0.008) in the intervention group versus controls.

Conclusion: Based on the findings of this study, montelukast use with a daily dose of 10 mg for 14 days could remarkably decrease inflammatory indices in patients with COVID-19 pneumonia. Further studies on this issue are strongly recommended.

Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials (identifier: IRCT20181208041886N3, https://www.irct.ir/trial/51633; ethical code #IR.MUI.MED. REC.1399.382).


Implication for health policy/practice/research/medical education:

Montelukast can remarkably decrease inflammatory indices in patients with COVID-19 pneumonia.

Please cite this paper as: Pourahmad M, Aria A, Momenzadeh M, Nikoukar F, Ataei B, Shams M, Shahzamani K, Nasirharandi S. Evaluation of the effect of montelukast drug in improving the clinical condition of patients with COVID-19 in referral hospitals in Isfahan; a randomized clinical trial. J Nephropharmacol. 2024;13(2):e11650. DOI: 10.34172/npj.2023.11650.

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