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Effect of long-term salmeterol treatment on exercise-induced asthma.
N Engl J Med. 1998 Jul 16; 339(3):141-6.NEJM

Abstract

BACKGROUND

With long-term administration of salmeterol, the extent of protection afforded by the drug against experimental precipitants of asthma such as methacholine and adenosine may decrease. Whether this effect extends to a clinically relevant stimulus such as exercise is unknown.

METHODS

We performed a random-order, double-blind, crossover trial in 20 patients with exercise-induced asthma. Each patient received inhaled salmeterol or placebo twice daily for a month, with a one-week washout period between treatments. The patients performed cycle ergometry while breathing frigid air 30 minutes after the morning dose and 9 hours later on the 1st, 14th, and 29th study days. The primary end point was the extent of the decrease in forced expiratory volume in 1 second (FEV1) 10 minutes after exertion.

RESULTS

With placebo, significant airway narrowing developed at all times (mean [+/-SE] decrease from base line in FEV1, 19+/-2 percent in the morning and 18+/-2 percent in the evening). The morning dose of salmeterol attenuated the degree of bronchoconstriction at all times (decrease in FEV1 on day 1, 5+/-2 percent; on day 14, 10+/-3 percent; and on day 29, 9+/-3 percent; P=0.10). Its ability to act throughout the day, however, decreased with long-term administration (decrease in FEV1 from morning to evening on day 1, 6+/-2 percent; on day 14, 15+/-3 percent; and on day 29, 14+/-3 percent; P=0.003).

CONCLUSIONS

Protection against exercise-induced asthma is maintained with long-term administration of salmeterol, but the length of time that the drug remains active after a single dose decreases.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, University Hospitals of Cleveland, OH 44106-5067, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9664089

Citation

Nelson, J A., et al. "Effect of Long-term Salmeterol Treatment On Exercise-induced Asthma." The New England Journal of Medicine, vol. 339, no. 3, 1998, pp. 141-6.
Nelson JA, Strauss L, Skowronski M, et al. Effect of long-term salmeterol treatment on exercise-induced asthma. N Engl J Med. 1998;339(3):141-6.
Nelson, J. A., Strauss, L., Skowronski, M., Ciufo, R., Novak, R., & McFadden, E. R. (1998). Effect of long-term salmeterol treatment on exercise-induced asthma. The New England Journal of Medicine, 339(3), 141-6.
Nelson JA, et al. Effect of Long-term Salmeterol Treatment On Exercise-induced Asthma. N Engl J Med. 1998 Jul 16;339(3):141-6. PubMed PMID: 9664089.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of long-term salmeterol treatment on exercise-induced asthma. AU - Nelson,J A, AU - Strauss,L, AU - Skowronski,M, AU - Ciufo,R, AU - Novak,R, AU - McFadden,E R,Jr PY - 1998/7/17/pubmed PY - 2001/3/28/medline PY - 1998/7/17/entrez SP - 141 EP - 6 JF - The New England journal of medicine JO - N Engl J Med VL - 339 IS - 3 N2 - BACKGROUND: With long-term administration of salmeterol, the extent of protection afforded by the drug against experimental precipitants of asthma such as methacholine and adenosine may decrease. Whether this effect extends to a clinically relevant stimulus such as exercise is unknown. METHODS: We performed a random-order, double-blind, crossover trial in 20 patients with exercise-induced asthma. Each patient received inhaled salmeterol or placebo twice daily for a month, with a one-week washout period between treatments. The patients performed cycle ergometry while breathing frigid air 30 minutes after the morning dose and 9 hours later on the 1st, 14th, and 29th study days. The primary end point was the extent of the decrease in forced expiratory volume in 1 second (FEV1) 10 minutes after exertion. RESULTS: With placebo, significant airway narrowing developed at all times (mean [+/-SE] decrease from base line in FEV1, 19+/-2 percent in the morning and 18+/-2 percent in the evening). The morning dose of salmeterol attenuated the degree of bronchoconstriction at all times (decrease in FEV1 on day 1, 5+/-2 percent; on day 14, 10+/-3 percent; and on day 29, 9+/-3 percent; P=0.10). Its ability to act throughout the day, however, decreased with long-term administration (decrease in FEV1 from morning to evening on day 1, 6+/-2 percent; on day 14, 15+/-3 percent; and on day 29, 14+/-3 percent; P=0.003). CONCLUSIONS: Protection against exercise-induced asthma is maintained with long-term administration of salmeterol, but the length of time that the drug remains active after a single dose decreases. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/9664089/Effect_of_long_term_salmeterol_treatment_on_exercise_induced_asthma_ L2 - https://www.nejm.org/doi/10.1056/NEJM199807163390301?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -