Montelukast for Children With Chronic Otitis Media With Effusion (COME): A Double-blind, Placebo-controlled Study

Overview[ - collapse ][ - ]

Purpose The purpose of our double-blind, placebo controlled study is to test the hypothesis that montelukast therapy might be associated with improved hearing in certain sub populations of children suffering from OME.
ConditionChronic Otitis Media With Effusion
Conductive Hearing Loss
InterventionDrug: Montelukast
PhaseN/A
SponsorTel-Aviv Sourasky Medical Center
Responsible PartyTel-Aviv Sourasky Medical Center
ClinicalTrials.gov IdentifierNCT01967498
First ReceivedOctober 17, 2013
Last UpdatedOctober 17, 2013
Last verifiedOctober 2013

Tracking Information[ + expand ][ + ]

First Received DateOctober 17, 2013
Last Updated DateOctober 17, 2013
Start DateNovember 2013
Estimated Primary Completion DateMay 2016
Current Primary Outcome Measuresimprovement of hearing of 10 db based on pure tone audiometry [Time Frame: 3 months] [Designated as safety issue: No]
Current Secondary Outcome Measuresimprovement of tympanometry graph to type A [Time Frame: 3 months] [Designated as safety issue: No]

Descriptive Information[ + expand ][ + ]

Brief TitleMontelukast for Children With Chronic Otitis Media With Effusion (COME): A Double-blind, Placebo-controlled Study
Official TitleMontelukast for Children With Chronic Otitis Media With Effusion (COME): A Double-blind, Placebo-controlled Study
Brief Summary
The purpose of our double-blind, placebo controlled study is to test the hypothesis that
montelukast therapy might be associated with improved hearing in certain sub populations of
children suffering from OME.
Detailed Description
Chronic otitis media with effusion is a common problem in children that sometimes causes
hearing impairment which may affect language development and quality of life of the child.
The standard treatment is surgical insertion of ventilation tubes. In the pediatric
population this procedure is preformed under general anesthesia and is associated with quite
a few possible complications.

In this study we will examine the effects of conservative treatment with montelukast on the
resolution of the effusion without surgical treatment .

Montelukast is a selective leukotriene receptor antagonist that is widely used for children
with asthma1. Allergic rhinitis in children is one of the approved indications for
Montelukast.

Montelukast's effect on OME has been studied in several previous studies. In 2004 a study by
Combs JT2 showed efficacy of 49% of Montelukast in clearing persistent OME post-AOM. This
study was not directed at patients with chronic OME and did not use audiometry as an
endpoint. Another study from 2005 by Balatsouras DG studied the effect of montelukast on
OME in children suffering from co-existing asthma. The rate of OME resolution after one
month of treatment was 60% as opposed to 36% in the control group. The endpoint of this
study was OME and not audiometry results. There was no additional followup. In 2010 Schoem
SR began a randomized control double blinded study testing the effect of montelukast on
children with confirmed OME of 2 months. Montelukast was given for one month. Although the
goal was to recruit 120 children, the study was halted after 38 were treated because a
statistical trend showed that there was no positive effect compared to the placebo group.

An additional study was published in 2007 performed as a RCT of 77 children did not prove
the drug's effectiveness as a treatment for OME . This study was published as an abstract
only and no details of the hearing or inclusion criteria were given. Montelukast has been
proven effective in resolving experimental OME in a rat model although as opposed to
methylpresnisone it did not reduce the submucosal neutrophil infiltrate.

The purpose of our double-blind, placebo controlled study is to test the hypothesis that
montelukast therapy might be associated with improved hearing in certain sub populations of
children suffering from OME.
Study TypeInterventional
Study PhaseN/A
Study DesignAllocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
Condition
  • Chronic Otitis Media With Effusion
  • Conductive Hearing Loss
InterventionDrug: Montelukast
Other Names:
Singulair
Study Arm (s)
  • Experimental: montelukast
    this arm will receive montelukast as the active intervention of the study
  • Placebo Comparator: placebo

Recruitment Information[ + expand ][ + ]

Recruitment StatusNot yet recruiting
Estimated Enrollment52
Estimated Completion DateMay 2016
Estimated Primary Completion DateDecember 2015
Eligibility Criteria
Inclusion Criteria:

- Documented persistent OME of at least 3 months (otoscopy or audiometry or
tympanometry)

- Patients between the ages of 2-10 being evaluated for VT surgery

- Tympanogram type B

- A conductive hearing loss greater than 20 DB

- Otoscopy confirming middle ear effusion

Exclusion Criteria:

- previous adenoidectomy or tonsillectomy

- history of ear surgery

- cleft palate, Down's syndrome, congenital, malformations of the ear or cholesteatoma

- Sensoneural hearing loss

- Allergy to montelukast

- Moderate or Severe OSA requiring surgery sooner than 3 months
GenderBoth
Ages2 Years
Accepts Healthy VolunteersAccepts Healthy Volunteers
ContactsNot Provided
Location CountriesNot Provided

Administrative Information[ + expand ][ + ]

NCT Number NCT01967498
Other Study ID NumbersTASMC-13-MH-0170-13-CTIL
Has Data Monitoring CommitteeNot Provided
Information Provided ByTel-Aviv Sourasky Medical Center
Study SponsorTel-Aviv Sourasky Medical Center
CollaboratorsNot Provided
Investigators Not Provided
Verification DateOctober 2013