ROLE OF MONTELUKAST IN PREVENTING RELAPSE IN CHILDHOOD IDIOPATHIC NEPHROTIC SYNDROME: A QUASI-EXPERIMENTAL STUDY
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Abstract
OBJECTIVE: To study the role of montelukast in preventing relapses in childhood idiopathic steroid sensitive nephrotic syndrome (SSNS).
METHODS: This quasi-experimental, open label study was conducted at Department of Paediatric Nephrology, The Children’s Hospital and The Institute of Child Health, Multan, Pakistan. Total of 106 patients with first-episode of nephrotic syndrome, aged 1-10 years were enrolled from February-May 2019 and non-randomly assigned to Group-A & Group-B (53 patients in each group). All patients in both groups were started on prednisolone 2mg/kg single morning dose for 4-weeks as per institutional protocol. Group-A (Cases) also received montelukast 5mg daily at bedtime for at least 12 months while Group-B (control) was not given montelukast. All patients were followed up for one year till May 2020 to monitor the response to treatment and evidence of relapse. Ten patients were excluded from final analysis due to loss to follow-up (n=3; 2 in Group-A and 1 in Group-B) or showing steroids resistance (n=7; 3 in Group-A and 4 in Group-B).
RESULTS: Out of 96 children (48 each in Group-A & B), 58 (60.4%) were males. Mean age was 4.7±1.9 years and most of children (n=64; 66.7%), were aged between 2-6 years. Overall relapse rate of 35.4% (n=34/98) was observed, with 9/48 (18.8%) patients in Group-A compared to 25/48 (52.1%) patients in Group-B (p<0.001). Out of 34 patients with relapse, 20 (58.8%) were males and 14 (41.2%) were females.
CONCLUSION: Montelukast showed significant efficacy in preventing relapse rate in children with SSNS during one year of follow-up.
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