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Effect of inhaled indomethacin on exercise-induced bronchoconstriction in children with asthma

T Shimizu1, H Mochizuki, M Shigeta

  • 1Department of Pediatrics, Gunma University School of Medicine, Japan.

Insights

Inhaled indomethacin, a nonsteroidal anti-inflammatory drug (NSAID), effectively reduced exercise-induced bronchoconstriction (EIB) in children with asthma. This treatment improved lung function and oxygen saturation after exercise challenges.

Area of Science:

  • Pediatric Pulmonology
  • Pharmacology
  • Respiratory Medicine

Background:

  • Exercise-induced bronchoconstriction (EIB) is a common condition in children with asthma.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) have shown potential in managing inflammatory airway conditions.

Purpose of the Study:

  • To evaluate the efficacy of inhaled indomethacin in mitigating exercise-induced bronchoconstriction (EIB) in pediatric asthma patients.
  • To assess the impact of inhaled indomethacin on lung function and arterial oxygen saturation following exercise challenges.

Main Methods:

  • A double-blind, randomized, crossover study involving nine children with asthma and a history of EIB.
  • Participants received either inhaled indomethacin (3 mg/m2 BSA) or placebo (0.9% saline) 15 minutes before an exercise challenge test.
  • Lung function (FEV1) and arterial oxygen saturation were measured post-exercise.

Main Results:

  • Inhaled indomethacin significantly attenuated EIB, reducing the maximal percent decrease in FEV1 from 36.1% with placebo to 18.0% with indomethacin (p = 0.0310).
  • Indomethacin also significantly reduced the maximal decrease in arterial oxygen saturation after exercise (p = 0.0378).

Conclusions:

  • Inhaled indomethacin demonstrates a protective effect against exercise-induced bronchoconstriction in children with asthma.
  • The mechanism may involve the inhibition of local prostaglandin synthesis and/or airway ion transport.

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