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Pilgrim's progress: the effect of salmeterol in older children with chronic severe asthma
S Langton Hewer1, J Hobbs, D French
1Royal Alexandra Hospital for Sick Children, Brighton, U.K.
Insights
Salmeterol significantly improved lung function in children with severe asthma. This long-acting beta-agonist demonstrated good tolerability and efficacy in a randomized controlled trial.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Clinical Trials
Background:
- Chronic severe asthma significantly impacts children's quality of life.
- Long-acting beta-agonists are a cornerstone in asthma management.
- Evidence for salmeterol's efficacy in severe pediatric asthma requires further investigation.
Purpose of the Study:
- To evaluate the efficacy and tolerability of salmeterol in children aged 12-17 with chronic severe asthma.
- To compare symptom scores, lung function, and quality of life between salmeterol and placebo groups.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 24 children with chronic severe asthma.
- Participants received either 100 micrograms salmeterol or placebo twice daily via dry powder inhalation.
- Assessments included symptom scores, peak expiratory flow rates, spirometry, and quality-of-life measures over one school term.
Main Results:
- Salmeterol treatment showed consistent improvements compared to placebo.
- Statistically significant improvements were observed in morning and evening peak expiratory flow rates and spirometry.
- No medication-related adverse events or pulse rate changes were recorded, indicating good tolerability.
Conclusions:
- Salmeterol (100 micrograms twice daily) is well-tolerated and effective for managing chronic severe asthma in adolescents.
- The study supports the use of salmeterol as an adjunct therapy in this patient population.
Abstract:
Twenty-four children aged 12-17 years entered a randomized, double-blind placebo-controlled study investigating the use of salmeterol in chronic severe asthma. In addition to their usual medication, the children were given either placebo or 100 micrograms salmeterol b.d. by dry powder inhalation. Treatment was continued throughout one term at a residential school for asthma. Symptom scores, peak expiratory flow rates, spirometry and quality-of-life scores were compared between the two treatment groups. One child withdrew during the run-in period. Twelve pupils received placebo and 11 pupils received salmeterol. There were consistent improvements in favour of salmeterol, reaching statistical significance for morning and evening peak flow rates and spirometry when measured on four occasions during the study period. There were no medication-related adverse events recorded and no pulse rate changes. Salmeterol (100 micrograms b.d.) is well tolerated and efficacious in older children with chronic severe asthma.