The Back to School asthma study: the effect of montelukast on asthma burden when initiated prophylactically at the start of the school year.
Summary of "The Back to School asthma study: the effect of montelukast on asthma burden when initiated prophylactically at the start of the school year."
Pediatric asthma hospitalizations peak in early autumn.
To determine the effectiveness of montelukast therapy in reducing the asthma burden in children when initiated prophylactically on school return.
This was a randomized, multicenter, double-blind, placebo-controlled study of children with asthma aged 6 to 14 years. No minimum asthma symptoms were required, and patients could continue inhaled corticosteroid (ICS) use. Montelukast, 5 mg, chewable tablet (n = 580) or matching placebo (n = 582) was taken the night before the first day of school and nightly thereafter for 8 weeks. The primary end point was the percentage of days with worsening asthma, defined by one of the following: (1) increased beta-agonist use, (2) increased daytime symptoms, (3) awake "all night," (4) oral corticosteroid rescue or increased ICS use for worsening asthma, or (5) unanticipated health care utilization.
The reduction in the percentage of days with worsening asthma with montelukast use versus placebo use was not significant (24.3% vs 27.2%, P = .07). Prespecified subgroup analyses demonstrated nonsignificant trends favoring montelukast therapy in boys and older children but no effect by baseline ICS use or history of cold symptoms. Post hoc analysis showed a nonsignificant trend favoring montelukast therapy in reducing worsening asthma days for children commencing school after August 15 compared with earlier commencement.
Montelukast use was not significantly more effective than was placebo use in reducing the percentage of days with worsening asthma when initiated at the start of the school year. The effect of montelukast treatment on the fall peak in asthma burden may depend on sex, age, and the date of school return.
Institute for Healthcare Studies and Department of Medicine, Northwestern Feinberg School of Medicine, Chicago, Illinois.
This article was published in the following journal.
Name: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20674830
- DOI: http://dx.doi.org/10.1016/j.anai.2010.04.018
Medical and Biotech [MESH] Definitions
Asthma attacks following a period of exercise. Usually the induced attack is short-lived and regresses spontaneously. The magnitude of postexertional airway obstruction is strongly influenced by the environment in which exercise is performed (i.e. inhalation of cold air during physical exertion markedly augments the severity of the airway obstruction; conversely, warm humid air blunts or abolishes it).
Drugs that are used to treat asthma.
A beta-adrenergic agonist used in the treatment of asthma and bronchospasms.
Adrenergic beta-2 agonist used as bronchodilator for emphysema, bronchitis and asthma.
An adrenergic beta-agonist used as a bronchodilator agent in asthma therapy.
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