Effect of long-term salmeterol treatment on exercise-induced asthma.

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: J A Nelson, L Strauss, M Skowronski, R Ciufo, R Novak, E R McFadden Jr
• Journal: The New England journal of medicine (N Engl J Med) Vol. 339 Issue 3 Pg. 141-6 (Jul 16 1998) ISSN: 0028-4793 [Print] United States
• PMID: 9664089 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Adrenergic beta-Agonists
• Bronchodilator Agents
• Salmeterol Xinafoate
• Albuterol

Topics

• Adrenergic beta-Agonists (pharmacology, therapeutic use)
• Adult
• Albuterol (analogs & derivatives, pharmacology, therapeutic use)
• Asthma, Exercise-Induced (drug therapy, physiopathology)
• Bronchoconstriction (drug effects)
• Bronchodilator Agents (pharmacology, therapeutic use)
• Cross-Over Studies
• Double-Blind Method
• Drug Tolerance
• Female
• Forced Expiratory Volume (drug effects)
• Humans
• Male
• Salmeterol Xinafoate
• Time Factors