Adverse drug reactions affecting treatment adherence in first-line treatment of asthma: An observational study

Semiha Bahceci Erdem; Hikmet Tekin Nacaroglu; Demet Can

doi:10.15586/aei.v51i2.774

Semiha Bahceci Erdem

Izmir Bakırçay University, Çiğli Training and Research Hospital Pediatric Immunology and Allergy, Izmir, Turkey.

Hikmet Tekin Nacaroglu

Department of Pediatric Allergy and Immunology, Istanbul Medipol University School of Medicine, Istanbul, Turkey.

Demet Can

Department of Pediatric Allergy and Immunology, Dr Behcet Uz Children’s Hospital, Izmir, Turkey.

Keywords

adherence, adverse drug reaction, asthma, hallucination, inhaled corticosteroids, leukotriene receptor antagonists, montelukast, steroid phobia

Abstract

Background: Asthma is the most common chronic lung disease among children. International guidelines recommend inhaled corticosteroids (ICS) as the first-line daily controller therapy for children with asthma and leukotriene receptor antagonists (LTRA) as the second alternative therapy. Adherence to treatment is the most significant component to optimize the benefits of therapy in asthma.

Objective: This study aims to investigate the frequency of drug discontinuation due to adverse drug reactions (ADRs) that affect adherence to treatment in children with asthma or asthma and allergic rhinitis using LTRA or ICS as monotherapy.

Methods: The subjects aged 4–18 years with asthma or asthma and allergic rhinitis and using montelukast or ICS as monotherapy were included in the study. They were evaluated in terms of ADRs affecting adherence to treatment in the first and third months of treatment.

Results: A total of 468 cases, 356 of whom received montelukast monotherapy and 112 of whom received ICS treatment, with a mean age of 9.10 ± 3.08 (4–17) years, were included in the study. Males constituted 65.6% of the total cases (n = 307). In the first month of follow-up of the cases, it was observed that 4.8% (n = 17) of the patients in the montelukast group could not continue the treatment due to ADR. It was determined that the drug discontinuation rate in the montelukast group in the first month was significantly higher than in the ICS group (P = 0.016), and the risk of drug discontinuation due to ADR in the montelukast group was 1.333 (95% CI, 1.26–1.40) times higher.

Conclusions: As a result, it was observed that the drug was discontinued due to ADR at a higher rate in children with asthma who received montelukast monotherapy compared to those who received ICS monotherapy.

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