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Comparison of montelukast versus budesonide in the treatment of exercise-induced bronchoconstriction.
Ann Allergy Asthma Immunol. 2001 Jun; 86(6):655-8.AA

Abstract

BACKGROUND

Previous studies in which leukotriene-receptor antagonist and corticosteroids were used have suggested a possible role for these anti-inflammatory drugs in the prevention of exercise-induced bronchoconstriction, but no direct comparisons have been made.

OBJECTIVE

A crossover study was undertaken to compare the ability of both montelukast and budesonide to protect patients from exercise-induced bronchoconstriction.

METHODS

A total of 20 patients (median age, 17 years; range, 8 to 36 years), who had clinical exercise-induced bronchoconstriction for 1 year and decreased FEV1 of at least 20% after exercise on two occasions, were enrolled in this study. To compare the therapies in each patient, we administered, consecutively, 10 mg of montelukast once daily at bedtime for 3 days and, later, 400 microg of budesonide twice daily for 15 days, or vice versa, with a 15-day intervening washout period during which no patient received treatment. Exercise challenges were performed at baseline (no therapy) and after each treatment. The percentage of FEV1 declines at 2, 7, and 12 minutes after exercise and the area under the curve (summarizing the extent and modification of FEV1 decreases relative to time) were measured and compared.

RESULTS

Both budesonide and montelukast significantly reduced the decrease in FEV1 (area under the curve) after exercise with respect to the baseline condition of no therapy (P = 0.0001). Overall, budesonide offered better protection (area under the curve) than did montelukast (P = 0.01), particularly in the short-term evaluation (2 minutes after exercise; P = 0.003); however, considerable individual variations in the responses to both budesonide and montelukast were observed. The degree of protection against decreases in FEV1 ranged from 0% to almost 100% for both treatments. In 16 of 20 patients, budesonide therapy offered better protection than did montelukast, and in the other 4 patients, montelukast showed better protection than did budesonide. No side effects of either montelukast or budesonide were detected during the study.

CONCLUSIONS

Treatment with budesonide or montelukast prevents exercise-induced bronchoconstriction. Because substantial variation in the response may be present among patients, both drugs should be tested in each patient before long-term therapy is chosen.

Authors+Show Affiliations

Allergy Unit, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain. mearturo@uscmail.usc.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11428738

Citation

Vidal, C, et al. "Comparison of Montelukast Versus Budesonide in the Treatment of Exercise-induced Bronchoconstriction." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 86, no. 6, 2001, pp. 655-8.
Vidal C, Fernández-Ovide E, Piñeiro J, et al. Comparison of montelukast versus budesonide in the treatment of exercise-induced bronchoconstriction. Ann Allergy Asthma Immunol. 2001;86(6):655-8.
Vidal, C., Fernández-Ovide, E., Piñeiro, J., Nuñez, R., & González-Quintela, A. (2001). Comparison of montelukast versus budesonide in the treatment of exercise-induced bronchoconstriction. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 86(6), 655-8.
Vidal C, et al. Comparison of Montelukast Versus Budesonide in the Treatment of Exercise-induced Bronchoconstriction. Ann Allergy Asthma Immunol. 2001;86(6):655-8. PubMed PMID: 11428738.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of montelukast versus budesonide in the treatment of exercise-induced bronchoconstriction. AU - Vidal,C, AU - Fernández-Ovide,E, AU - Piñeiro,J, AU - Nuñez,R, AU - González-Quintela,A, PY - 2001/6/29/pubmed PY - 2001/9/21/medline PY - 2001/6/29/entrez SP - 655 EP - 8 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann Allergy Asthma Immunol VL - 86 IS - 6 N2 - BACKGROUND: Previous studies in which leukotriene-receptor antagonist and corticosteroids were used have suggested a possible role for these anti-inflammatory drugs in the prevention of exercise-induced bronchoconstriction, but no direct comparisons have been made. OBJECTIVE: A crossover study was undertaken to compare the ability of both montelukast and budesonide to protect patients from exercise-induced bronchoconstriction. METHODS: A total of 20 patients (median age, 17 years; range, 8 to 36 years), who had clinical exercise-induced bronchoconstriction for 1 year and decreased FEV1 of at least 20% after exercise on two occasions, were enrolled in this study. To compare the therapies in each patient, we administered, consecutively, 10 mg of montelukast once daily at bedtime for 3 days and, later, 400 microg of budesonide twice daily for 15 days, or vice versa, with a 15-day intervening washout period during which no patient received treatment. Exercise challenges were performed at baseline (no therapy) and after each treatment. The percentage of FEV1 declines at 2, 7, and 12 minutes after exercise and the area under the curve (summarizing the extent and modification of FEV1 decreases relative to time) were measured and compared. RESULTS: Both budesonide and montelukast significantly reduced the decrease in FEV1 (area under the curve) after exercise with respect to the baseline condition of no therapy (P = 0.0001). Overall, budesonide offered better protection (area under the curve) than did montelukast (P = 0.01), particularly in the short-term evaluation (2 minutes after exercise; P = 0.003); however, considerable individual variations in the responses to both budesonide and montelukast were observed. The degree of protection against decreases in FEV1 ranged from 0% to almost 100% for both treatments. In 16 of 20 patients, budesonide therapy offered better protection than did montelukast, and in the other 4 patients, montelukast showed better protection than did budesonide. No side effects of either montelukast or budesonide were detected during the study. CONCLUSIONS: Treatment with budesonide or montelukast prevents exercise-induced bronchoconstriction. Because substantial variation in the response may be present among patients, both drugs should be tested in each patient before long-term therapy is chosen. SN - 1081-1206 UR - https://www.unboundmedicine.com/medline/citation/11428738/Comparison_of_montelukast_versus_budesonide_in_the_treatment_of_exercise_induced_bronchoconstriction_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1081-1206(10)62294-6 DB - PRIME DP - Unbound Medicine ER -