Time-effect of montelukast on protection against exercise-induced bronchoconstriction

Respir Med. 2011 Dec;105(12):1790-7. doi: 10.1016/j.rmed.2011.08.007. Epub 2011 Aug 23.

Abstract

Introduction: Montelukast has been proven to assure a protective effect against exercise-induced bronchoconstriction.

Aim: To verify exactly when montelukast begins protection in asthmatic children by evaluating different time intervals between dosing and challenge.

Methods: In a double blind, placebo-controlled, three day doses, crossover study, patients were randomized to receive in sequence treatment with either a placebo or montelukast and assigned to one of seven groups that were tested 1, 2, 3, 4, 5, 6 and 8 h after drug administration, respectively. For each group, the exercise challenge was always performed at the same hour on the first and third days of treatment.

Results: Sixty-nine asthmatic children took part in the study. On day 3, the mean FEV(1) % fall from baseline was 25.54 (95% CI = 21.63/29.46) and 14.89 (95% CI = 11.85/17.92) for the placebo and active drug (p < 0.05), respectively. On day 1, the mean fall of FEV(1) was 28.20 (95% CI = 24.46/31.94) and 19.01 (95% CI = 15.71/22.31) for the placebo and montelukast (p < 0.05), respectively. Clinical protection was achieved in 21 (30%) and 33 (48%) subjects by montelukast on the first and third days, respectively.

Conclusions: Montelukast assured protection against exercise-induced bronchoconstriction from the first through the eighth hour from the first day of treatment. However, individual susceptibility to protection was evident since some individuals were not protected at any time. We conclude that in clinical use individual responses to the drug should be carefully evaluated in the follow-up management.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetates / pharmacology
  • Acetates / therapeutic use*
  • Asthma, Exercise-Induced / drug therapy*
  • Asthma, Exercise-Induced / physiopathology
  • Asthma, Exercise-Induced / prevention & control
  • Bronchoconstriction / drug effects*
  • Child
  • Cross-Over Studies
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Exercise Test
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Leukotriene Antagonists / pharmacology
  • Leukotriene Antagonists / therapeutic use*
  • Male
  • Quinolines / pharmacology
  • Quinolines / therapeutic use*
  • Time Factors

Substances

  • Acetates
  • Leukotriene Antagonists
  • Quinolines
  • montelukast