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Monday 17 December 2001

Asthma Drug Safe for Young Kids

By: Michael Smith

Your child's asthma inhaler is a lifesaver, but it makes her heart race. Well she may soon have an alternative. Researchers are now testing a drug that's already on the market for adults, to see if it can be safely used in kids under 12.

Albuterol 'rescue' inhalers -- Proventil and Ventolin -- are key to treating asthma attacks. They can be used in kids 4 years and up when breathing becomes difficult.

But these inhalers contain a mixture of two types of albuterol: one that helps ease breathing, and another that, according to the researchers, has little benefit and may even harm the airways of people with asthma.

A new medicine called Xopenex is a very similar inhaler, but is missing the part of albuterol that is believed to cause most of the side effects, such as a racing heart and elevated blood sugar. Right now, however, the FDA has only recommended Xopenex for people 12 years and older.

Researchers looked at more than 300 children with asthma, aged 4 to 11. Although Albuterol and Xopenex are typically given when an asthma attack hits, in this study the children took the drug three times a day -- in a low or high dose -- to formally test its effectiveness and side effects.

The kids received albuterol as either the complete mixture (Proventil or Ventolin) or as Xopenex, or a placebo.

The study results appear in the December issue of The Journal of Allergy and Clinical Immunology. Sepracor Inc., makers of Xopenex, sponsored the study.

The low-dose of Xopenex -- half what is given to adults -- worked better than the higher dose of the albuterol mixture. Plus, Xopenex worked faster and had fewer side effects. In fact, the half-dose of Xopenex produced no more heart racing or abnormal sugar levels than the placebo did. This wasn't true for those with the most severe asthma, however, and the researchers suggest these patients may benefit from the higher Xopenex dose.

Currently, the albuterol mixtures Proventil and Ventolin are used in children under 12. But the researchers in this study found that even the low dose of these mixtures produced side effects and didn't work as well as Xopenex.

"Many asthma patients do perfectly well on the less expensive [albuterol mixtures]," says lead author Henry Milgrom, MD, in a news release. "But our findings indicate that asthmatic children who use their rescue inhalers several times a day are likely to get more benefits with fewer side effects from [Xopenex]." Milgrom is a senior faculty member at National Jewish Medical and Research Center in Denver, Colo.

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