Asthma Drug Soothes RSV-Related Cough
Singulair May Help Babies With Common Lung Condition Breathe Easier
Feb. 14, 2003 -- A drug used to treat asthma may also calm the
wheezing and coughing associated with a lung condition common among babies
known as respiratory syncytial virus (RSV). New research shows Singulair
(montelukast) eased symptoms and helped infants recover from some of the
lingering lung and other breathing problems that frequently follow RSV.
According to the American Academy of Pediatrics (AAP), RSV is
the most common cause of lower respiratory tract infections in children and is
the leading cause of hospitalization for babies under 1 year old. More than
125,000 infants with RSV are hospitalized each year and about 2% die.
Babies become infected with RSV by the time they reach age 2.
In most healthy infants, the virus causes only cold-like symptoms such as
cough, fever, and runny nose. But in certain, high-risk infants, such as those
born prematurely or with lung disease, RSV can cause serious complications and
Researchers say many infants who are hospitalized with RSV
continue to suffer from wheeze and other asthma-like symptoms long after they
"We don't know if these symptoms are actually due to the
RSV, asthma, or something else in these children," researcher Hans
Bisgaard, MD, professor of pediatrics at Copenhagen University Hospital tells
Some studies have suggested that babies who suffer from
post-RSV wheeze and cough are more likely to develop asthma later in childhood,
but that link isn't clear.
But researchers do know that during serious RSV cases infants
release substances known as leukotrienes in the lungs, which are thought to
contribute to the dangerous inflammation that occurs.
"This drug [Singulair] blocks leukotrienes," says
Bisgaard. "And since we know leukotrienes are one of the mediators of
post-RSV wheeze, we decided to target them. Just like taking an antihistamine
for hay fever blocks the mediator that causes those symptoms."
Researchers compared the effects of daily treatment with a 5 mg
chewable tablet of Singulair with placebo in 116 infants who were hospitalized
for RSV. The treatment began within seven days after the start of RSV symptoms
and lasted for 28 days.
The results appear in the Feb. 1 issue of American Journal
of Respiratory and Critical Care Medicine.
Babies who were treated with the drug were symptom-free on six
(22%) of the 28 days and nights compared with only one (4%) among those who
received the placebo. Daytime coughing was also significantly reduced among the
In addition, a worsening of symptoms requiring withdrawal from
the study or hospitalization occurred in only four of the infants on Singulair
versus 10 of those on the placebo, and these exacerbations were significantly
delayed in the treated infants.
Experts say these findings clear the way for further studies
into the long-term effectiveness of these types of drugs on RSV-related wheeze
and cough, as well as new ways of fighting RSV itself.