The following is a summary of “Montelukast as a repurposable additive drug for standard-efficacy multiple sclerosis treatment: Emulating clinical trials with retrospective administrative health claims data,” published in the April 2024 issue of Neurology by Manuel et al.

New treatment options are needed for multiple sclerosis (MS), while the study is being conducted to determine the potential of Montelukast, a leukotriene receptor antagonist (LTRA), as an add-on therapy.

Researchers conducted a retrospective study investigating whether montelukast reduces relapse rates in people with multiple sclerosis (pwMS).

They utilized two separate longitudinal claims databases to simulate RCTs. The PwMS aged 18-65 years, concurrently on MS disease-modifying therapies, were identified in de-identified claims from Optum’s Clinformatics® Data Mart (CDM) and IQVIA PharMetrics® Plus for Academics. Among them, 483 cases of pwMS on montelukast with medication adherence were recorded in CDM, and 208 were recorded in PharMetrics Plus for Academics. Controls were randomly selected from 35,330 pwMS without montelukast prescriptions in CDM and 10,128 in PharMetrics Plus for Academics. Over 2 years, relapses were tracked through inpatient hospitalization and corticosteroid claims. Adjusting patients for confounders and censoring, a doubly robust causal inference model estimated the effects of montelukast.

The results showed a marked decrease of 23.6% in relapses among pwMS treated with montelukast compared to non-users across 67.3% of simulated RCTs.

Investigators concluded a benefit for montelukast in reducing MS relapses, highlighting the need for future clinical trials to explore this potential further.

Source: journals.sagepub.com/doi/10.1177/13524585241240398