Eric P. Brestel, MD
Brestel E.; Oral Montelukast versus Inhaled Salmeterol To Prevent Exercise-Induced Bronchoconstriction. Ann Intern Med. 2000;133:392. doi: 10.7326/0003-4819-133-5-200009050-00020
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Published: Ann Intern Med. 2000;133(5):392.
TO THE EDITOR:
I would like to express my concerns about the study comparing montelukast with salmeterol in the long-term treatment of exercise-induced bronchoconstriction (1). Several questions come to mind.
First, why do such a study? Most people do not exercise more than once daily, and one or two inhalations of a short-acting β-agonist is effective at a fraction of the cost of salmeterol and montelukast. My second concern is the requirement that anti-inflammatory medications (corticosteroids) be withdrawn. According to the authors, their patients met the criteria for moderate asthma; the recommendation of the National Heart, Lung, and Blood Institute is that such patients receive anti-inflammatory medication. Two patients withdrew from the study because of worsening asthma, and one died!
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