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Airway mechanics after withdrawal of a leukotriene receptor antagonist in children with mild persistent asthma: Double‐blind, randomized, cross‐over study
Author(s) -
Kim Ju Hee,
Lee Shinhae,
Shin Youn Ho,
Ha Eun Kyo,
Lee Seung Won,
Kim MiAe,
Yoon Jung Won,
Baek Hey Sung,
Choi SunHee,
Han Man Yong
Publication year - 2020
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.25085
Subject(s) - medicine , montelukast , placebo , spirometry , asthma , anesthesia , bronchodilator , salbutamol , leukotriene receptor , crossover study , inhalation , alternative medicine , pathology
Background To determine the response of airway mechanics and the changes in asthma symptoms to stepping down of leukotriene receptor antagonist (LTRA) therapy. Methods Thirty children (mean age: 7.1 years) with mild, well‐controlled, and persistent asthma who took LTRA as maintenance treatment were randomized into a double‐blind, placebo‐controlled, cross‐over study. Each group received an LTRA (montelukast) or placebo daily for 2 weeks, followed by a 1‐week washout period, and then the alternate treatment for 2 weeks. Spirometry and impulse oscillation system (IOS) measurements before and after four puffs of salbutamol inhalation, fractional exhaled nitric oxide (FeNO), and the childhood asthma control test (C‐ACT) were evaluated at baseline, the end of placebo treatment, and the end of LTRA treatment. Results Changes of FEV 1 /FVC ( p = .113) and FEV 1 ( p = .109) from baseline to posttreatment did not differ significantly between the placebo and montelukast groups. In the placebo group, prebronchodilator (pre‐) FEV 1 /FVC was decreased (83% vs. 86%) and bronchodilator response (BDR) in FEV 1 was diminished (10.7% vs. 6.4%) at posttreatment compared with baseline. However, the montelukast group had no significant changes in pre‐FEV 1 /FVC ( p = .865) and BDR in FEV 1 ( p = .461). In addition, compared with the montelukast group, the placebo group showed no significant changes in Rrs5 (total airway resistance), Rrs5–20 (peripheral airway resistance), FeNO, and symptoms by the C‐ACT. Conclusion In children with well‐controlled mild persistent asthma, changes in spirometry, IOS, FeNO, and C‐ACT results did not differ between the placebo and montelukast groups within 2 weeks.