Effect of different antiasthmatic treatments on exercise-induced bronchoconstriction in children with asthma.
BACKGROUND
Exercise-induced bronchoconstriction occurs in a large proportion of children with asthma, limiting everyday activities important for their physical and social development.


OBJECTIVE
The purpose of this randomized, double-blind, placebo-controlled study was to compare the ability of different patterns of antiasthmatic treatment, recommended in childhood asthma, to protect patients from exercise-induced bronchoconstriction.


METHODS
Children 6 to 18 years of age with atopic asthma were randomized to a 4-week, placebo-controlled, double-blind trial. Patients were randomly allocated to receive daily 200 microg budesonide (twice daily, 100 microg per dose) + 9 microg formoterol (twice daily, 4.5 microg per dose; n = 20); 200 microg budesonide + 5 or 10 mg montelukast (once daily at bedtime; n = 20); 5 or 10 mg montelukast (n = 20); 200 microg budesonide (n = 20); or placebo (n = 20). A standardized treadmill exercise challenge was performed before and after treatment.


RESULTS
Exercise-induced bronchoconstriction, reflected by area under the curve for the FEV1 values from exercise over the 20-minute period and by maximum percent fall in FEV1 after exercise, was significantly diminished after 4 weeks in all active treatment groups, and compared with placebo. Exercise-induced bronchoconstriction protection improved more significantly in the budesonide + montelukast and montelukast groups compared with other therapeutic options.


CONCLUSIONS
These data indicate differences in effects on exercise-induced bronchoconstriction between therapeutic options recommended in childhood asthma. Control of childhood asthma with exercise-induced bronchoconstriction can be obtained by using regular controller treatment.
Stelmach
Iwona
I
Department of Pediatrics and Allergy, Medical University of Lodz, Lodz, Poland. alergol@kopernik.lodz.pl
Grzelewski
Tomasz
T
Majak
Pawel
P
Jerzynska
Joanna
J
Stelmach
Wlodzimierz
W
Kuna
Piotr
P
D000085:Acetates / Q000627:therapeutic use; D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D039741:Antigens, Dermatophagoides / Q000276:immunology; D001249:Asthma / Q000503:physiopathology*; D016084:Bronchoconstriction / Q000187:drug effects*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D019819:Budesonide / Q000627:therapeutic use; D002648:Child; D003521:Cyclopropanes; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004983:Ethanolamines / Q000627:therapeutic use; D015444:Exercise; D005260:Female; D005541:Forced Expiratory Volume; D000068759:Formoterol Fumarate; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D008297:Male; D011804:Quinolines / Q000627:therapeutic use; D013440:Sulfides; D016896:Treatment Outcome
D000085:Acetates; D018927:Anti-Asthmatic Agents; D039741:Antigens, Dermatophagoides; D001993:Bronchodilator Agents; D003521:Cyclopropanes; D004983:Ethanolamines; D005938:Glucocorticoids; D011804:Quinolines; D013440:Sulfides; D019819:Budesonide; C093875:montelukast; D000068759:Formoterol Fumarate