Long-term circadian effects of salmeterol in asthmatic children treated with inhaled corticosteroids

Am J Respir Crit Care Med. 1995 Dec;152(6 Pt 1):1887-92. doi: 10.1164/ajrccm.152.6.8520751.

Abstract

The present study was set up to investigate whether salmeterol in children with asthma already treated with inhaled corticosteroids (ICS) leads to a sustained bronchodilator effect and decreased bronchial responsiveness, both during the day and night. Furthermore, we investigated whether cessation of salmeterol leads to a rebound increase in bronchial responsiveness. Forty children with asthma (aged 7-15 yrs) using ICS participated in a randomized, double-blind, parallel study. They received either twice daily 50 micrograms salmeterol or placebo. FEV1 and provocative concentration of methacholine that caused a 20% fall in FEV1 (PC20) were measured at 4:00 P.M. and 4:00 A.M. at baseline and after 16 wk. The same measurements were performed at 4:00 P.M. at 8 h after the first dose, and after 1 and 8 wk. After cessation of the study drug, FEV1 and PC20 were measured at 12 and 20 h and after 1 wk. Overall mean FEV1 from 1 to 16 wk of treatment was significantly higher in the salmeterol group than in the placebo group (difference, 4.9 +/- 2.0%, p = 0.01). Evolution in time of FEV1 did not differ significantly between the two groups (p = 0.09). Overall mean PC20 from 1 to 16 wk of treatment was not significantly higher with salmeterol than with placebo (difference, 0.7 +/- 0.4 doubling dose [DD] p = 0.07); evolution in time of PC20 did not differ significantly between the two groups (p = 0.58).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Albuterol / analogs & derivatives*
  • Albuterol / therapeutic use
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Beclomethasone / administration & dosage
  • Beclomethasone / therapeutic use
  • Bronchial Provocation Tests
  • Bronchoconstrictor Agents
  • Bronchodilator Agents / therapeutic use*
  • Child
  • Circadian Rhythm*
  • Double-Blind Method
  • Female
  • Forced Expiratory Volume
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Methacholine Chloride
  • Salmeterol Xinafoate

Substances

  • Bronchoconstrictor Agents
  • Bronchodilator Agents
  • Glucocorticoids
  • Methacholine Chloride
  • Salmeterol Xinafoate
  • Beclomethasone
  • Albuterol