Original
Role of Montelukast in Reducing the Rate of Relapse of Childhood Idiopathic Nephrotic Syndrome
*Akter S,1 Hoque M,2 Chowdhury MZ,3 Ahmed A,4 Mollah MS,5 Rahman N6
- *Dr. Salma Akter, MD(Paediatrics), Resident, Department of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh. salmatania0123@gmail.com. ORCID: https://orcid.org/0009-0007-0848-1880
- Professor Dr. Mujibul Hoque, Department of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet.
- Professor Dr. Md Ziaur Rahman Chowdhury, Principal and Head, Department of Paediatrics, Sylhet MAG Osmani Medical College.
- Proessor Dr. Akhlaq Ahmed, Professor of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet.
- Dr. Muhammad Solaiman Mollah, DCH, FCPS(Paediatrics), Associate Professor, Department of Paediatrics, Sylhet MAG Osmani Medical college, Sylhet. ORCID: https://orcid.org/0009-0007-9007-3965
- Dr. Naima Rahman, MD (Paediatrics), Department of Paediatrics, Sylhet MAG Osmani Medical college, Sylhet. ORCID: https://orcid.org/0009-0003-4524-0542
*For correspondence
Abstract
Background: Relapse of idiopathic nephrotic syndrome is caused by overexpression of IL-13. Montelukast a leukotriene receptor antagonist that may reduce relapse by inhibiting IL-13.
Objective: To assess the effect of montelukast in reducing the rate of relapse of childhood idiopathic nephrotic syndrome.
Methods: A randomized controlled trial was conducted in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital, Sylhet from January 2023 to October 2024. A total of 104 children with 1st attack of nephrotic syndrome aged 2 to 10 years were included. Every case was allocated to either Group-A or group-B by block randomization. Thus, each group consisted of 52 children. Prednisolone was started in both groups in a dose of 60mg/m2 daily for 6 weeks. Then, prednisolone was given in a dose of 40 mg/m2 every alternate day for another 6 weeks. Group A (cases) also received montelukast (4mg for children up to5 years of age and 5 mg for children aged 6 years and above) for 12 months. In group B (control) montelukast was not given. Patients in both groups were followed up 3 monthly for one year to monitor the number of relapse and adverse effect of montelukast. Thirteen patients were excluded from final analysis due to lost to follow up (n = 6; 3 in group A and 3 in group B) or steroid resistance (n = 7; 4 in group -A and 3 in group -B).
Results: Out of 91 children (45 in group –A and 46 in group –B), 49(53.8%) patients had relapse. Relapse rate was significantly higher in group -B than group A (71.7% vs 35.6%). In group A, majority 7 (43.8%) had relapse at 9 months whereas in group B, 16 (48.5%) had relapse at 6 months, that was significant between two groups. In group A, 13 (81.3%) patients had IFRNS (Infrequent relapse nephrotic syndrome) whereas in group B, 15 (45.5%) had FRNS (Frequent relapse nephrotic syndrome), the difference between two groups were statistically significant (p=.001). Few adverse effects of montelukast were found.
Conclusion: The result of this study showed that montelukast is effective in reducing the rate of relapse of childhood idiopathic nephrotic syndrome.
[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):138-143]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.6