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Abstract
Background: Asthma is a chronic inflammatory airway illness, which impacts about 399 million people globally, and a significant proportion is numbered among children in Pakistan. Majority of mild to moderate persistent asthma needs optimal control in order to avoid morbidity and enhance the quality of life. The most frequently used controller therapies include montelukast (antihistamine leukotriene receptor antagonist) and ketotifen (mast cell stabilizer with antihistaminic effects), but there is a paucity of comparative data in pediatric groups.
Objective: To compare outcome of ketotifen versus montelukast in mild to moderate persistent asthma in children 5-15 years of age.
Methodology: This was a randomized clinical trial carried out at the Department of pediatrics, Children Hospital and Institute of child health, Lahore during July 2024 and December 2024. Sixty children who fitted the inclusion criteria were recruited and randomly divided into two groups (n=30 each). Group A was given ketotifen syrup (0.2mg/mL, 5mL twice a day), and Group B was prescribed montelukast 5mg one time a day over a period of three months. At the baseline and monthly follow-ups, the Asthma Control Test (ACT) score was used to measure asthma control. The data were examined by the use of SPSS version 20 where post-stratification independent t-test was used. A p-value ≤0.05 was considered significant.
Results: The ACT score of the montelukast group was significantly greater than that of the ketotifen group (21.4 +/- 2.3 vs 18.6 +/- 2.9; p=0.001). A higher percentage of patients had well-controlled asthma in the montelukast (73.3) group as opposed to ketotifen (43.3) group.
Conclusion: Montelukast was more effective than ketotifen in asthma control of children with mild to moderate persistent asthma. It can be used as a first line adjunct control therapy in this group of people.