[The value and safety of disodium chromoglycate in asthma]

Abstract

Disodium cromoglycate has been shown experimentally and by clinical trials to be a useful addition to available treatment for asthma. Follow jp studies have shown no loss of effect with continuous use. Bronchodilators and steroid treatment is used less, resulting in benefits in the overall safety of treatment. Studies of patients treated for more than three years continuously have failed to show evidence of toxic effects. The greatest dangers associated with cromoglycate are failure of some patients to continue treatment as instructed and the possibility of temporary loss of effect during acute attacks of asthma when no inhaled treatment can be effective and systemic treatment is essential. The method of action of disodium cromoglycate is the stabilisation of mast cells resulting in a less ready release of mediator substances, thus causing a reduced asthmatic response. This protective effect could not be obtained after challenge, but it is present if the drug was inhaled prior to challenge. Disodium cromoglycate has been shown experimentally and by clinical trials to be a useful addition to available treatment for asthma. Follow up studies have shown no loss of effect with continuous use. Bronchodilators and steroid treatment is used less, resulting in benefits in the overall safety of treatment. Studies of patients treated for more than three years continuously have failed to show evidence of toxic effects. The greatest dangers associated with cromoglycate are failure of some patients to continue treatment as instructed and the possibility of temporary loss of effect during acute attacks of asthma when no inhaled treatment can be effective and systemic treatment is essential. A study carried out on 242 children showed that 65% clearly benefited from cromoglycate and 57 out of 96 who were on continuous steroid therapy were able to discontinue the steroid treatment. Recently, 998 patients treated with cromoglycate were reviewed for evidence of toxic effects. The most serious side effects observed were hoarse voice due to larynx irritation caused by the inhaled powder, clearing up after discontinuation of the drug. Severe cases of asthma controlled with cromoglycate or any toher inhaled therapy may experience relapses, which could be managed by a prompt systemic treatment.