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Meta-Analysis
. 2008 Oct 8;2008(4):CD002173.
doi: 10.1002/14651858.CD002173.pub2.

Inhaled sodium cromoglycate for asthma in children

Johannes C van der Wouden  1 , Johannes H J M Uijen, Roos M D Bernsen, Marjolein J A Tasche, Johan C de Jongste, Francine Ducharme
Affiliations
Meta-Analysis

Inhaled sodium cromoglycate for asthma in children

Johannes C van der Wouden et al. Cochrane Database Syst Rev. .

Abstract

Background: Sodium cromoglycate has been recommended as maintenance treatment for childhood asthma for many years. Its use has decreased since 1990, when inhaled corticosteroids became popular, but it is still used in many countries.

Objectives: To determine the efficacy of sodium cromoglycate compared to placebo in the prophylactic treatment of children with asthma.

Search strategy: We searched the Cochrane Airways Group Trials Register (October 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2007), MEDLINE (January 1966 to November 2007), EMBASE (January 1985 to November 2007) and reference lists of articles. We also contacted the pharmaceutical company manufacturing sodium cromoglycate. In 2007 we updated the review.

Selection criteria: All double-blind, placebo-controlled randomised trials, which addressed the effectiveness of inhaled sodium cromoglycate as maintenance therapy, studying children aged 0 up to 18 years with asthma.

Data collection and analysis: Two authors independently assessed trial quality and extracted data. We pooled study results.

Main results: Of 3500 titles retrieved from the literature, 24 papers reporting on 23 studies could be included in the review. The studies were published between 1970 and 1997 and together included 1026 participants. Most were cross-over studies. Few studies provided sufficient information to judge the concealment of allocation. Four studies provided results for the percentage of symptom-free days. Pooling the results did not reveal a statistically significant difference between sodium cromoglycate and placebo. For the other pooled outcomes, most of the symptom-related outcomes and bronchodilator use showed statistically significant results, but treatment effects were small. Considering the confidence intervals of the outcome measures, a clinically relevant effect of sodium cromoglycate cannot be excluded. The funnel plot showed an under-representation of small studies with negative results, suggesting publication bias.

Authors' conclusions: There is insufficient evidence to be sure about the efficacy of sodium cromoglycate over placebo. Publication bias is likely to have overestimated the beneficial effects of sodium cromoglycate as maintenance therapy in childhood asthma.

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Conflict of interest statement

The authors were involved in a placebo‐controlled trial (Tasche 1997) and in an earlier systematic review comparing DSCG and placebo (Tasche 2000). Both studies had negative conclusions.

Figures

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1
Methodological quality summary: review authors' judgments about each methodological quality item for each included study.
2
2
Forest plot of the primary outcome of the review: mean difference in % symptom‐free days between sodium cromoglycate and placebo
3
3
Forest plot of mean difference in symptom scores for day cough between sodium cromoglycate and placebo
4
4
Forest plot of mean difference in symptom scores for day wheeze between sodium cromoglycate and placebo
5
5
Forest plot of mean difference in overall symptoms between sodium cromoglycate and placebo
6
6
Forest plot of mean difference in bronchodilator use between sodium cromoglycate and placebo
7
7
See this image and copyright information in PMC

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References

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Masood 1978 {published data only}
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Mellon 1982 {published data only}
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Miraglia 1981 {published data only}
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Molema 1989 {published data only}
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Munro Ford 1969 {published data only}
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Pesic 1975 {published data only}
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References to other published versions of this review

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