Comparison of inhaler corticosteroids and oral montelukast in children with reactive airways disease.

Abstract

Objective: To compare the efficacy of inhaler corticosteroids and oral montelukast in children with reactive airways disease. Study Design: Randomized Controlled Trial. Setting: Department of Pediatrics, Lady Reading Hospital, Peshawar. Period: 20 July 2025 to 20 January 2026. Methods: A total of 60 children aged 1 to 5 year with reactive airway disease for more than 3 months were enrolled using a 95% confidence level and 80% power calculation. Participant were randomized into two equal groups of 30 each. Group A received inhaler corticosteroids at 200 microgram per day and Group B received oral montelukast at 4 mg once daily in children below 1 year and 5 mg once daily in children above 1 year. Efficacy was defined as complete absence of symptom after 3 months of treatment. Chi-square test and Fischer exact test were applied to compare efficacy between groups and across stratified variables. Results: Inhaler corticosteroids showed efficacy in 73.3% patients compared to 33.3% with oral montelukast (p=0.002). Age-stratified analysis showed significant efficacy in children aged 3 years or less (77.8% versus 40.0%, p=0.041). Female gender demonstrated superior response to inhaler corticosteroids (84.6% versus 35.3%, p=0.012). Urban residents showed better efficacy with inhaler corticosteroids (76.5% versus 31.3%, p=0.007). Conclusion: Inhaler corticosteroids are significantly more effective than oral montelukast in managing reactive airways disease in children.