In the placebo group, when the theophylline dose was reduced and then finally stopped, there was a deterioration in symptoms despite an increased use of inhaled bronchodilator. In the nedocromil sodium group, however, patients appeared able to tolerate the reduction and withdrawal of theophylline therapy— symptom scores and inhaled bronchodilator usage were lower than baseline during the period when the theophylline dose was reduced and were not significantly different from the baseline when theophylline therapy was stopped.

Baseline severity of asthma was assessed when these patients were receiving their usual therapy of sus-tained-release theophylline and inhaled p2-broncho-dilators. The results therefore suggest that nedocromil sodium can substitute for theophylline without a deterioration in asthma status. This was also indicated by the assessments of asthma severity and the comments on the success of withdrawal of theophylline therapy. Withdrawal led to a worsening of symptoms in the majority of patients in both treatment groups. Symptoms, however, were already markedly improved in the nedocromil sodium group and this “worsening” represented the return of the prenedocromil sodium level of control.In the long-term management of asthma, the addition of nedocromil sodium to maintenance bronchodilator therapy should meet the need to treat the chronic bronchial inflammation and associated bronchial hyperreactivity that underlies the disease process, as well as providing symptomatic relief.’ asthma mist asthma relief

Nedocromil sodium has been shown to prevent the increase in nonspecific bronchial hyperreactivity that occurs in pollen-sensitive asthmatics during the pollen season and to reduce bronchial responsiveness to methacholine to the same extent as beclomethasone dipropionate in nonatopic asthmatics. In contrast, bronchodilator therapy has not been shown to reduce bronchial hyperreactivity in the long term. Overreliance on bronchodilators and underutilization of preventive treatments are considered to have contributed to asthma mortality in recent years.* Nedocromil sodium was highly effective and well tolerated in this study. It is therefore possible to define several clinical situations where nedocromil sodium may be used effectively: in the reduction or replacement of an existing dosage of theophylline; in patients for whom theophylline is indicated but who show intolerance; and as an adjunct to existing therapy in patients who have room for improvement.

Conclusion

Nedocromil sodium, 4 mg twice daily, conferred significant benefit when added to the therapy of asthmatic patients maintained on a regimen of bronchodilator therapy (sustained-release theophylline plus inhaled p2~bronchodilators). The results suggest that nedocromil sodium may permit a reduction in theophylline dosage and possibly substitute for theophylline in previously dependent patients.

Category: asthma / Tags: Bronchodilator therapy, Chronic Asthma, Nedocromil Sodium