Montelukast as a Repurposable Additive Drug for Standard-Efficacy Multiple Sclerosis Treatment: Emulating Clinical Trials With Retrospective Administrative Health Claims Data

Authors

Astrid M Manuel
Assaf Gottlieb
Leorah Freeman
Zhongming Zhao

Publication Date

5-1-2024

Journal

Multiple Sclerosis Journal

Abstract

BACKGROUND: Effective and safe treatment options for multiple sclerosis (MS) are still needed. Montelukast, a leukotriene receptor antagonist (LTRA) currently indicated for asthma or allergic rhinitis, may provide an additional therapeutic approach.

OBJECTIVE: The study aimed to evaluate the effects of montelukast on the relapses of people with MS (pwMS).

METHODS: In this retrospective case-control study, two independent longitudinal claims datasets were used to emulate randomized clinical trials (RCTs). We identified pwMS aged 18-65 years, on MS disease-modifying therapies concomitantly, in de-identified claims from Optum's Clinformatics

RESULTS: pwMS treated with montelukast demonstrated a statistically significant 23.6% reduction in relapses compared to non-users in 67.3% of emulated RCTs.

CONCLUSION: Real-world evidence suggested that montelukast reduces MS relapses, warranting future clinical trials and further research on LTRAs' potential mechanism in MS.

Keywords

Humans, Sulfides, Cyclopropanes, Quinolines, Acetates, Adult, Middle Aged, Female, Male, Retrospective Studies, Leukotriene Antagonists, Multiple Sclerosis, Young Adult, Case-Control Studies, Adolescent, Aged, Administrative Claims, Healthcare, Recurrence

Comments

Supplementary Materials

PMID: 38660773