Steroid puff best for kids with persistent asthma
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In a study of children with mild-to-moderate persistent asthma, treatment with fluticasone (Flovent), an inhaled steroid, was consistently more effective than treatment with montelukast (Singulair), an oral anti-asthma drug from the leukotriene receptor antagonist (LTRA) class of agents, investigators report.
In the 8-week crossover study of 127 asthmatic children 6 to 17 years of age, fluticasone was associated with significantly more asthma-free days, better asthma control, and decreased need for albuterol “rescue” puffs, compared with montelukast, the investigators report.
Fluticasone also produced significantly greater improvements in various measures of lung function, Dr. Robert S. Zeiger, from the University of California, San Diego, and associates report in the Journal of Allergy and Clinical Immunology.
These findings, the authors conclude, support recommendations for inhaled corticosteroids as the preferred first-line controller therapy for mild-to-moderate persistent childhood asthma. Up until now, there has been relatively little information available about the use of LTRAs in children with asthma, they point out.
Given these results, does montelukast have a place in treatment of pediatric asthma patients? “Patients who had a high degree of allergic airway inflammation and indicators consistent with allergic airway inflammation should be directed to an inhaled steroid,” answered co-author Dr. Stanley J. Szefler, from the National Jewish Medical & Research Center in Denver, Colorado. “Others could receive a trial of either medication.”
SOURCE: Journal of Allergy and Clinical Immunology January 2006.
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