Prevention of Exercise-induced Asthma by a Fixed Combination of Disodium Cromoglycate plus Reproterol Compared with Montelukast in Young Patients

Abstract

Background:

The leukotriene inhibitor montelukast has been recommended against exercise-induced asthma (EIA), however, single-dose agents might be favourable in several aspects.

Objective:

To compare the protective effects against EIA of a single inhalation of the combination disodium cromoglycate (DSCG, CAS 16110-51-3) and reproterol (REP, CAS 54063-54-6) with 3 days oral treatment of montelukast (MON, CAS 158966-92-8).

Methods:

Open-label, cross-over, single-centre trial. Twenty-four 6 to 18-year-old children and adolescents, with reversible and stable airway obstruction, baseline FEV1, > 70 %, predicted and proven EIA (i.e. a maximum decrease of FEV₁ by ≥ 20% compared with baseline) were treated with MON, orally for 3 days in the evening, or one single inhalation of DSCG/REP 20 min before the exercise challenge. The treatment sequence was randomised. The exercise test on a treadmill was performed under standardised conditions.

Results:

24 patients completed both periods. Both treatments clearly provided protection against EIA; however, protection of DSCG/REP was more pronounced than that of MON. This difference was statistically significant even if the data were adjusted for the increase in FEV₁ between inhalation of DSCG/REP and challenge (DSCG/REP_adjusted). The nadir FEV₁, level after exercise following prophylaxis with DSCG/REP was even higher than the pre-inhalation FEV₁, value. From these data, protection indices of 66 %, 81 %, and 113% for MON, DSCG/REP_adjusted, and DSCG/REP_unadjusted, respectively, were estimated.

Conclusions:

Inhalation of DSCG/REP before exercise provides significantly better protection against EIA than three days treatment with MON.

Key words

Antiasthmatic drugs - CAS 16110-51-3 - CAS 54063-54-6 - CAS 158966-92-8 - Disodium cromoglycate - Exercise-induced asthma, children - Montelukast - Reproterol

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