Daily asthma meds keep lungs in play during exercise
Taking asthma medication daily can help prevent the tightening of the airways or “bronchoconstriction” with physical exertion that affects many children with asthma, a new study from Poland confirms.
Dr. Iwona Stelmach of N. Copernicus Hospital in Lodz and colleagues found that of the four treatments they evaluated, the two including the anti-asthma drug montelukast (Singulair) were the most effective, but all were better than placebo.
“Control of childhood asthma with exercise-induced bronchoconstriction can be obtained by using regular controller treatment,” Stelmach and colleagues write in the Journal of Allergy and Clinical Immunology.
Children may often forget to take bronchodilators before exercising, the researchers note, but daily medications can also help make airways less hyperresponsive to exertion, and don’t have to be taken right before children exercise.
The researchers compared the effectiveness of four different daily treatment approaches: budesonide (Pulmicort turboinhlaer) and formoterol (Oxis turboinhaler); budesonide and montelukast; montelukast alone; and budesonide alone.
They randomized 100 children with exercise-induced bronchoconstriction to one of the treatments or placebo for four weeks. All of the children had a treadmill exercise test before and after treatment.
All children who received active asthma treatment showed a significant reduction in exercise-induced airway tightening, but improvements were greatest in the montelukast-only and montelukast-plus-budesonide groups.
There was no difference between the two montelukast groups, suggesting that budesonide didn’t have an additional effect. However, the researchers say, this could have been because the study was too small to detect the difference.
“It can be argued that adding montelukast should be recommended to achieve better control of exercise-induced bronchoconstriction in children with asthma,” they conclude.
SOURCE: Journal of Allergy and Clinical Immunology, February 2008.
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