Chronic cough-variant asthma (CCVA) is a very common subtype of bronchial asthma among children population. This condition often manifests with acute cough, chronic cough, and intractable cough, especially at night. It has been reported that CCVA contributed 24.0% to 33.3% of chronic cough cases, and children alone accounted for the incidence of 0.18% among the total chronic cough-variant asthma population.

Pharmacotherapy is predominantly used for the treatment of patients with CVA. Such intervention includes glucocorticoids, antihistamine drugs, β2-agonists, and leukotriene receptor antagonists (LTRAs). Of those medications, LTRAs have been used as the first-line treatment for such condition, and montelukast comprises the most commonly used type 1 cysteinyl leukotriene antagonist.

In this retrospective study, authors investigated the effectiveness and safety of montelukast and budesonide for the treatment of children with Chronic cough-variant asthma (CCVA) aged 4 to 11 years.

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The anti-inflammatory effects of montelukast are regarded to be milder as compared to inhaled corticosteroids in the management of asthma; most studies used it as an add-on therapy to budesonide.

It has been reported that the combination of Montelukast and Budesonide (MCB) may help to better manage the symptom control, lung function improvement, and also against the airway narrow protection compared with inhaled corticosteroids alone.

Montelukast was administered as a 4 mg chewable tablet each evening and budesonide 1 mg tablet three times daily.

The investigators reported that after 8 weeks of treatment, patients receiving the combination demonstrated better outcomes in lung function, measured by peak expiratory flow rate (PEFR) and forced expiratory volume in 1 second (FEV₁).

The group receiving the combination also had better clinical assessment scores, including on measures of wheeze, activity, cough and sleep. In addition, no serious AEs occurred in this study. 

FEV₁ increased from baseline to 8 weeks in the combination treatment group by approximately 17% while there was an approximate 9% increase in the group receiving budesonide alone. PEFR was improved by approximately 12% in the combination treatment group, while those on budesonide improved by 4%.

The results of this study demonstrate that the effectiveness of montelukast combined budesonide is superior to budesonide alone in the treatment of children with chronic cough-variant asthma in children aged 4 to 11 years.