Asthma in Children
Conditions
Brief summary
Randomized controlled trial in 80 children with mild to persistent moderate asthma, who were randomized to receive montelukast 5mg + loratadine 5mg vs. montelukast 5mg + placebo for loratadine to evaluate the efficacy in terms of improvement of symptoms. Secondary outcome was the days off without the use of rescue medication; reduction of levels of cysteinyl leukotrienes (Cys-LTS), nitric oxide (FeNO), intracellular adhesion molecule type 1 (ICAM-1) and interleukin 8 (IL-8) in condensed exhaled air; the improvement of day and night symptoms; the reduction in the frequency of night awakenings; the improvement in the quality of life; the percentage of related adverse events; the need to use systemic steroids; the number of visits to the emergency department secondary to the presence of an asthma attack; the number of hospitalizations secondary to asthma attacks; and the improvement in the percentage of FEV1 in relation to the predicted.
Detailed description
Asthma is a disease with increasing prevalence worldwide that produces significant deterioration of the quality of life in children and development of important complications and economic, social impact. Considering the concept of a common airway (coexistence of asthma and rhinitis), joint management initiatives with anti-asthmatics and anti-histamines have been published. The primary objective of this clinical trial is to evaluate the efficacy and safety of the use of montelukast + loratadine in children with asthma on the improvement of symptoms and secondarily to evaluate the impact on a) the days off without the use of rescue medication; b) reduction of levels of cysteinyl leukotrienes (Cys-LTS), nitric oxide (FeNO), intracellular adhesion molecule type 1 (ICAM-1) and interleukin 8 (IL-8) in condensed exhaled air; c) the improvement of day and night symptoms; d) the reduction in the frequency of night awakenings; e) the improvement in the quality of life; f) the percentage of related adverse events; g) the need to use systemic steroids; h) the number of visits to the emergency department secondary to the presence of an asthma attack; i) the number of hospitalizations secondary to asthma attacks; and j) the improvement in the percentage of FEV1 in relation to the predicted. We included 80 children from 6 to 12 years old, any sex, with mild to moderate persistent asthma, after signing an informed consent letter by parents or guardians or signing the child's consent (\> 8 years). Children with chronic diseases associated with the disease of interest were excluded (heart disease, nephropathy, liver disease of any kind); with any other lung disease other than asthma; with a history of hypersensitivity to montelukast or loratadine or with a history of concomitant use of medications that interact significantly with montelukast or loratadine
Interventions
Montelukast 5mg mixed with Loratadine 5mg, one dose per day
Montelukast 5mg
Sponsors
Study design
Masking description
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Children allocated on different arms will receive montelukast + loratadine vs. montelukast + placebo. Both product are identical in appearence and flavor
Intervention model description
Randomized clinical crossover trial, in 80 children who were allocated to receive montelukast + loratadine vs montelukast in two different periods of 4 weeks each, with a 2 weeks of wash-out between periods of treatment
Eligibility
Inclusion criteria
* Age from 6 to 12 years old * Any sex * Persistent mild to moderate asthma * Signature of informed consent letter by parents or guardians * Letter of assent of the minor for children over 9 years of age
Exclusion criteria
* Chronic pathologies associated with the disease of interest (heart disease, nephropathy, liver disease of any kind) * Any other lung disease other than asthma * History of hypersensitivity to montelukast or loratadine * Concomitant use of medications that interact significantly with montelukast or loratadine
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Free of symptoms | 10 weeks | Number of days free of symptoms associated to asthma episodes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Reduction of airway inflammatory profile | 10 weeks | Measurement of inflamatory biomarkers in exhaled respiratory air |
| Reduction of awakenings | 10 weeks | Frequency of nocturn awakenings |
| Free of rescue medication | 10 weeks | Number of days free for use of rescue medications |
| Emergency visits | 10 weeks | Number of emergency visits secondary to asthma crisis |
| Adverse Events | 10 weeks | Frequency of reported adverse events |
| Quality of Life | 10 weeks | Changes in PedsQL during the treatment |