Oral Asthma Medication Found Helpful
An oral asthma medication can reduce symptoms in children who have intermittent asthma flare-ups linked to infection, a new study states in the American Journal of Respiratory and Critical Care Medicine.
"For the first time ever, an option for treatment of viral-induced intermittent asthma has proven effective," says study author Dr. Hans Bisgaard, a professor of pediatrics at Copenhagen University Hospital in Denmark.
After taking the medication Singulair® (montelukast) for 12 months, the children in the study had a 32 percent reduced rate of asthma exacerbations, while their use of inhaled corticosteroid medications was reduced by 40 percent.
Singulair is a leukotriene receptor antagonist, which is the first medication in this new class of asthma medications designed to stop the airway inflammation associated with asthma before it starts.
For many people with intermittent asthma, viral infections, such as a cold, trigger inflammation and asthma symptoms. In fact, according to the study authors, viral infections may be responsible for up to 85 percent of asthma symptoms and exacerbations.
"Viral upper respiratory infections are a big asthma trigger," says Dr. Clifford Bassett, a fellow of the American Academy of Allergy, Asthma, and Immunology, and medical director of Allergy and Asthma Care of New York.
"Often, people only have asthma symptoms when they have a viral infection," Dr. Bassett says.
This study was especially interesting because it looked at treatment for intermittent asthma, whereas most studies focus on more severe, persistent asthma, notes Dr. Bassett.
Dr. Bisgaard and his colleagues included about 550 children between the ages of two and five. The children were from 68 different health-care sites and 23 countries. All had a history of intermittent asthma symptoms.
Two hundred and seventy-eight youngsters were given montelukast daily for a year. They were given the standard dose of either 4 milligrams or 5 milligrams, depending on their age. The remaining 271 youngsters were given a placebo (inactive substance).
The youngsters taking montelukast had 31.9 percent fewer asthma exacerbations and 31.6 percent fewer asthma episodes.
The children receiving the medication needed to take inhaled corticosteroids 40 percent less than children on placebo. The rate of oral corticosteroid use was reduced 17.5 percent in the montelukast group, compared to placebo.
According to Dr. Bisgaard, montelukast was well-tolerated in this study, and other studies have not shown any long-term side effects.
"Montelukast is very easy to use, and people like that it's an oral medication," Dr. Bassett says.
Drs. Bisgaard and Bassett agree that further study is necessary, particularly to see if taking montelukast at the first sign of a viral infection can control asthma as well as when taking the medication long-term.
Dr. Bassett adds that people with asthma, or parents of children with asthma, should make sure they have an asthma action plan.
"Talk with your doctor before anything happens, don't wait until Saturday night at three o'clock in the morning," Dr. Bassett explains. "Have preset instructions and medications on hand."
The study was funded by Merck and Co., the maker of Singulair.
Always consult your child's physician for more information.
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The use of medications in children is highly individualized, based on the severity of the child's symptoms, the age of the child, and the ability of the child to take inhaled medications.
The following are the most commonly used medications:
bronchodilators
These medications are used to help open the narrowed bronchi (air passages) and may relieve coughing, wheezing, shortness of breath, or difficulty in breathing.
These are usually considered "rescue medications" for acute attacks of asthma.
Types of bronchodilators are beta-agonists, theophylline, and anticholinergics.
These medications come in inhaler form, in pill form, liquid, or injectables.
The short-acting bronchodilators are used as needed as symptoms occur.
Longer acting bronchodilators may be used for maintenance or on a daily basis to help prevent flare-ups from occurring.
anti-inflammatory medications
These medications help to decrease inflammation that occurs in the airways with asthma.
These include two types of medications:
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nonsteroidal anti-inflammatory medications (NSAIDs)
Cromolyn and nedocromil are two types of nonsteroidal medications that are usually inhaled by the child.
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corticosteroids
These medications can be given in a variety of ways. Some of them are inhaled, while others may be taken as a pill or liquid, or even as an injection.
The steroids taken by mouth can have more side effects than those that are inhaled. Inhaled steroids are safe and effective controller medications and should be taken every day.
Consult your child's physician about the best choice for your child.
anti-leukotrienes
These are a relatively new type of medication being used to help control the symptoms of asthma.
These medications help to decrease the narrowing of the air passages and to decrease the chance of fluids in the lungs. These are usually given by mouth.
Always consult your child's physician for a diagnosis.
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