Montelukast is a leukotriene receptor antagonist used to treat wheeze but its value in young children is unproven. The WAIT trial therefore assessed the effectiveness of intermittently dosed montelukast in 1,358 children aged 10 months to 5 years.
Study results reported in The Lancet Respiratory Medicine (online, 9 September 2014)
show that montelukast was no more effective than placebo for reducing unscheduled medical attendances for wheezing episodes. However, subgroup analysis indicated that the treatment benefit varied according to the arachidonate 5-lipoxygenase (ALOX5) promoter genotype, with montelukast outperforming placebo in children with the 5/5 ALOX5 variant.
“Further data from stratified trials are needed before treatment is targeted to a responsive subgroup,” conclude Jonathan Grigg, from Queen Mary University of London, and co-authors.
 Nwokoro C, Pandya H, Turner S et al. Intermittent montelukast in children aged 10 months to 5 years with wheeze (WAIT trial): a multicentre, randomised, placebo-controlled trial. The Lancet Respiratory Medicine. doi:10.1016/S2213-2600(14)70186-9 (accessed 9 September 2014)