Emergency department visits and hospital admissions for acute asthma represent a considerable burden on health services worldwide. Many patients presenting with acute asthma do not respond fully to standard therapy of beta2agonists, corticosteroids and oxygen so additional therapies are required. Fast-acting LTRAs may potentially be helpful but guidelines report insufficient evidence to support their use during an asthma exacerbation. This Cochrane Review looked at whether adding LTRAs to standard treatment for people having an asthma attacks in the emergency department was beneficial or not. The primary outcome was hospital admissions. We identified six trials randomising 470 children to receive monteleukast or placebo in addition to standard care (nebulised