Montelukast add-on improves inhaler benefits in kids’ exercise-induced asthma

ADDING once-daily Singulair (montelukast) to the inhaled corticosteroid fluticasone provides superior bronchoprotection against exercise-induced asthma in children.

US and Brazilian researchers randomised 154 children aged six to 14 years, with persistent asthma, to receive either montelukast or salmeterol for four weeks, in addition to fluticasone 100-µg twice daily.

They found those who received montelukast (5 mg once daily) had significantly reduced average decreases in lung function after exercise compared with salmeterol (50- µg twice daily).

In addition, response to rescue medication after the exercise challenge was significantly greater with montelukast than with salmeterol.

“Addition of montelukast to a regimen of inhaled corticosteroids may afford more consistent protection against exercise-induced bronchoconstriction than long-acting beta-agonists,” the authors said.

Professor Peter van Asperen, head of the department of respiratory medicine at the Children’s Hospital at Westmead, said the results of the study showed montelukast was an “excellent” add-on alternative to help control asthma triggered by exercise in children.

“Introducing Singulair (montelukast) in children not adequately controlled on ICS alone can reduce their reliance on reliever medication and optimise their ability to perform daily activities without the development of the tolerance or tachyphylaxis to short-acting beta-agonists such as salbutamol,” he said.

Montelukast was recently added to the PBS as an add-on to inhaled corticosteroids for the prevention of exercise-induced asthma in children aged six to 14 years.

The study was sponsored by Merck Sharp & Dohme, manufacturers of montelukast. 

GlaxoSmithKline, manufacturers of salmeterol, did not wish to comment on the findings.

Ann Allergy Asthma & Immunol 2010:104:511-17.