Asthma drug 'isn't working on children' and could be making their illness worse

Doctors have warned a popular asthma drug used by tens of thousands of children may not work

A popular asthma drug used by tens of thousands of children may not work – and could even be making their illness worse, doctors have warned.
They say a genetic quirk means salmeterol does not help in one in seven cases.
With research showing that an alternative, montelukast, improves symptoms, they called on the Department of Health to provide new guidance.
Possibilities include giving asthmatic youngsters a £15 genetic test to work out the best treatment for them.
Somnath Mukhopadhyay, of Brighton and Sussex Medical School, said: ‘A common medication is not working in a significant proportion of the population.’
He said that when symptoms don't improve doctors often blame the mother for not giving the salmeterol properly, rather than concluding the drug isn’t working.
He said: ‘I think the time has come to move forward and be able to provide some clinical guidance to the parents.’
Treatment of asthma follows a series of steps, with a new drug being added to the package if the previous combination doesn’t work.
Children are typically first prescribed a drug to take to open up their airways during an attack. This often comes in a blue inhaler.
If that alone isn’t enough, they’ll be prescribed low-dose steroids, which may be in a brown inhaler.
If their asthma still isn’t under control, they’ll usually be given salmeterol, in a purple or green inhaler, and up to 100,000 British children are on all three drugs.
With a previous study suggesting that a particular gene stops some of the drugs form working in some children, Professor Mukhopadhyay and colleagues from Dundee University decided to compare salmeterol with another medicine called montelukast.

 

Sixty two children with the key gene took one of the drugs for a year and their health and quality of life was closely monitored.
Across the population as a whole, salmeterol works better than montelukast. But in these particular children, the reverse was true, the journal Clinical Science reports.
Those taking montelukast became less reliant on other drugs, their quality of life improved, they wheezed and coughed less and missed school less often.
In contrast, the health of those taking salmeterol did not improve and may even have got worse, said the professor.

 

Doctors have now urged the Department of Health to provide new guidance