MONTELUKAST ONCE-DAILY INHIBITS EXERCISE-INDUCED BRONCHOCONSTRICTION IN 6-YEAR-OLD TO 14-YEAR-OLD CHILDREN WITH ASTHMA

Objective: To determine whether montelukast, a leukotriene receptor an tagonist, attenuates exercise-induced bronchoconstriction (EIB) in 6- to 14-year-old children with asthma. Study design: Double-blind, multi center, 2-period crossover study. Children (n = 27) with forced expira tory volume in I second (FEV1) greater than or equal to 70% of the pre dicted value and a fall in FEV1 greater than or equal to 20% after exe rcise on 2 occasions. Patients received montelukast (5-mg chewable tab let) or placebo once daily in the evening far 2 days in crossover fash ion (at least 4 days between treatment periods). Standardized exercise challenges were performed 20 to 24 hours after the last dose in each period. End points included area above the postexercise percent fall i n FEV1 versus time curve (AAC(0-60min)) maximum percent fall in FEV1 f rom pre-exercise baseline, and time to recovery of FEV1 to within 5% o f pre-xercise baseline. Results: Montelukast significantly reduced AAC (0-60min) (265 vs 590 % . min for montelukast and placebo, respectivel y, P less than or equal to .05; similar to 59% protection relative to placebo) and the maximum percent fall (18% vs 26% for montelukast and placebo, respectively, P less than or equal to .05). Montelukast treat ment resulted in a shorter time to recovery (18 vs 28 minutes for mont elukast and placebo, respectively, P = .079). Conclusions: Montelukast attenuates EIB at the end of the dosing interval in 6- to 14-year-old children with asthma.