Drug curbs asthma flares tied to the common cold

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Young children with occasional mild bouts of asthma triggered largely by catching the common cold may be helped by treatment with the asthma drug Singulair, results of a study show.

Singulair, a so-called controller asthma medication, is known to be effective in controlling persistent asthma in adults, school children and preschoolers.

In the current study, researchers found that once-daily Singulair for one year could help ward off asthma exacerbations in 2- to 5-year-olds who only experienced these episodes during times of respiratory infection with rhinovirus and other common cold viruses.

"This study is the first to demonstrate that exacerbations of mild intermittent asthma can be successfully treated with a controller agent,” Dr. Hans Bisgaard from Copenhagen University Hospital in Denmark and colleagues note in the American Journal of Respiratory and Critical Care Medicine this month.

While they don’t anticipate that children with mild occasional asthma would be treated with Singulair on a daily basis, year-round, the investigators do think that it might be worthwhile to start a controller asthma drug before the flu season, when the risk of asthma flare-ups is high, or at the onset of an upper respiratory tract infection. They caution though that studies looking at the benefits and drawbacks of this approach need to be performed.

In their study, Bisgaard and others randomly assigned 549 children 2 to 5 years of age, who had a history of asthma attacks associated with respiratory infections but minimal asthma symptoms between bouts of the cold, to one chewable tablet of Singulair or an inactive dummy tablet daily for 12 months.

They found that Singulair was generally well tolerated and markedly lowered the rate of asthma exacerbations related to respiratory tract infections by a noteworthy 32%.

Singulair also delayed the time to the first asthma flare-up and reduced the need for inhaled asthma medications but did not reduce the length or severity of an asthma exacerbation after it started.

“The results of this study should be confirmed,” the authors say, “because they have broad implications for the treatment of intermittent asthma in children.”

Singulair, also known as montelukast, blocks leukotrienes, which are substances produced by a type of blood cell. Leukotrienes appear to play a role in the lung inflammation that characterizes asthma.

The study was supported by Merck and Company, maker of Singulair.

SOURCE: American Journal of Respiratory and Critical Care Medicine, February 2005. 

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