Salmeterol versus sodium cromoglycate for the protection of exercise induced asthma in children--a randomised cross-over study.
OBJECTIVE
Physical activity is an important and frequent trigger of airways obstruction in asthmatic children. We aimed to compare the efficacies of 50 microg salmeterol twice daily and 2 mg SCG four times daily with respect to protection from exercise induced bronchoconstriction (EIB).


METHODS
Twenty seven children and adolescents aged 4 to 16 years with mild or moderate exercise induced asthma (FEV1 70% to 90% predicted) were admitted to the study. Exercise challenge was performed on a treadmill using a predefined protocol in order to produce 10 minutes of exercise at near-maximum targets. The trial had a randomised, cross-over design comprising a 3-day run-in period and two 7-day treatment periods, separated by a one-week washout period.


RESULTS
The mean protective efficacy of salmeterol was larger than that of SCG. A difference between treatments of 39.7% (95% CI, - 0,8 to 68.9%) in favour of salmeterol was calculated using a Hodges-Lehmann-estimate. The maximum post-challenge fall in FEV subset 1 was significantly lower (p<0.001) after salmeterol than after SCG (- 5.6 +/- 6.4% vs. -12.1 +/- 9.3%, respectively). In addition, salmeterol improved base-line lung function to a greater degree than SCG. FEV1 increased by 0.4 l/sec after salmeterol, whereas no improvement was observed after SCG.


CONCLUSIONS
A one-week treatment with salmeterol 50 microg b.i.d in asthmatic children and adolescents provided better protection against EIB and improved baseline lung function as compared to SCG four times daily.
Zimmermann
Theodor
T
Universitätsklinik für Kinder und Jugendliche, Loschgestr. 15, D-91054 Erlangen, Germany. trzimmer@kinder.imed.uni-erlangen.de
Gulyas
A
A
Bauer
C P
CP
Steinkamp
G
G
Trautmann
M
M
D000293:Adolescent; D000420:Albuterol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology* / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D001250:Asthma, Exercise-Induced / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D001993:Bronchodilator Agents / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004205:Cromolyn Sodium / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D018592:Cross-Over Studies; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology; D008297:Male; D000068299:Salmeterol Xinafoate
D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents; D000068299:Salmeterol Xinafoate; D004205:Cromolyn Sodium; D000420:Albuterol