Why Does Salmeterol Worsen Asthma Symptoms In Some Children?

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Main Category: Respiratory / Asthma
Also Included In: Genetics;  Pediatrics / Children's Health
Article Date: 11 Jan 2013 - 10:00 PST


Some children with asthma have a gene that makes them respond to the medication Salmeterol very badly. Researchers have found that for these kids, taking this drug can actually worsen their condition.

One in seven sufferers of Asthma have the arginine-16 genotype of the beta-2 receptor which makes them respond badly to the beta-receptor stimulant, Salmeterol.

The researchers stress that in order to tackle this problem, it is crucial that children with asthma are tested to see whether they carry the genotype. By doing so, healthcare professionals can determine the best approach for treating them.

The study involved comparing different treatments given to asthmatic children who still experienced symptoms following the use of a inhaled steroid preventer.

Of the million children in the UK with asthma, more than 150,000 have a genetic change that makes them react badly to Salmeterol. They monitored 62 children with the arginine-16 genotype, all of them had to either missed school or sought treatment at hospital due to their asthma, even though they were taking prescribed inhaled steroids.

The children were split into two different groups and given different forms of treatment along with their usual preventer. One group took the inflammatory medicine Monktelukast while the second were on Salmeterol.

Children on Salmeterol showed no improvement

The scientists found that the children on Montelukast improved significantly more than those on Salmeterol. Not only did they experience an overall improved quality of life, they coughed a lot less and weren't as likely to experience a deterioration of their symptoms.

Half of the children in the group taking Montelukast didn't have to take their daily reliever at the end of the year, whereas those in the Salmeterol group showed no improvement whatsoever. This comes as somewhat of a surprise, considering that Salmeterol is the more common type of drug prescribed for children.

The researchers state that there are many children with asthma who are suffering at the moment because they are responding badly to Salmeterol. They emphasize that the only way to determine what the most effective form of treatment is, is by carrying out an inexpensive gene test.

A previous study led by a team of Cochrane Researchers concluded that some people with asthma who use salmeterol are at a greater risk of serious adverse events than those on other forms of asthma medication.

They believe that this finding is another step towards making asthma treatment more personalized and tailored.

Professor Brian Lipworth and Professor Colin Palmer, both from the University of Dundee, along with Professor Somnath Mukhopadhyay from the Brighton and Sussex Medical School, led the research which was published in the journal Clinical Science.

Written by Joseph Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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