Montelukast once daily inhibits exercise-induced bronchoconstriction in 6- to 14-year-old children with asthma

Objective: To determine whether montelukast, a leukotriene receptor antagonist, attenuates exercise-induced bronchoconstriction (EIB) in 6- to 14-year-old children with asthma. Study design: Double-blind, multicenter, 2-period crossover study. Children (n = 27) with forced expiratory volume in I second (FEV1) greater than or equal to 70% of the predicted value and a fall in FEV1 greater than or equal to 20% after exercise on 2 occasions. Patients received montelukast (5-mg chewable tablet) or placebo once daily in the evening far 2 days in crossover fashion (at least 4 days between treatment periods). Standardized exercise challenges were performed 20 to 24 hours after the last dose in each period. End points included area above the postexercise percent fall in FEV1 versus time curve (AAC(0-60min)) maximum percent fall in FEV1 from pre-exercise baseline, and time to recovery of FEV1 to within 5% of pre-xercise baseline. Results: Montelukast significantly reduced AAC(0-60min) (265 vs 590 % . min for montelukast and placebo, respectively, P less than or equal to .05; similar to 59% protection relative to placebo) and the maximum percent fall (18% vs 26% for montelukast and placebo, respectively, P less than or equal to .05). Montelukast treatment resulted in a shorter time to recovery (18 vs 28 minutes for montelukast and placebo, respectively, P = .079). Conclusions: Montelukast attenuates EIB at the end of the dosing interval in 6- to 14-year-old children with asthma.