Prevention of asthma with ketotifen in preasthmatic children: a three-year follow-up study

Area of Science:

• Pediatrics
• Allergology
• Pharmacology

Background:

• Growing asthma morbidity and mortality necessitate novel prevention strategies.
• Current approaches to prevent asthma in genetically predisposed children lack a universally accepted management scheme.
• Identifying and intervening in preasthmatic infants is crucial for effective asthma prevention.

Purpose of the Study:

• To evaluate the efficacy of ketotifen in preventing the onset of asthma in high-risk infants (preasthmatic).
• To assess ketotifen's effectiveness in a double-blind, placebo-controlled trial.

Main Methods:

• A 3-year double-blind, placebo-controlled, parallel study involving 100 infants at high risk for asthma.
• Participants had a family history of major allergy and elevated serum IgE, but no prior respiratory obstruction.
• Infants were randomized to receive either ketotifen (n=50) or placebo (n=50).

Main Results:

• Asthma developed in 9% (4/45) of infants treated with ketotifen versus 35% (14/40) of those receiving placebo (P = 0.003).
• No significant baseline differences were observed between the ketotifen and placebo groups regarding age, sex, allergy history, IgE levels, or smoking habits.
• The study demonstrated a statistically significant reduction in asthma onset with ketotifen treatment.

Conclusions:

• Ketotifen is effective in preventing the onset of asthma in preasthmatic infants.
• Early intervention with ketotifen may be a viable strategy for managing high-risk infants and reducing asthma prevalence.
• Further research should explore long-term outcomes and optimal treatment durations.