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/REPadjusted). 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/REPadjusted, and DSCG/REPunadjusted, 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
