Withdrawal of inhaled corticosteroid under cover of nedocromil sodium

Patients satisfactorily controlled on both an inhaled corticosteroid and a regularly inhaled bronchodilator were randomly allocated to 12 weeks of treatment with either nedocromil sodium (4 mg q.i.d.) or matching placebo. After 3 weeks of treatment, inhaled steroids were abruptly withdrawn. Severity of asthma deteriorated in both groups but more rapidly in the placebo group (p less than 0.05). Lung function tests showed little between-group difference. Nedocromil sodium had greater efficacy than placebo in the control of asthma in patients requiring an inhaled corticosteroid but abrupt corticosteroid withdrawal is not recommended. However, there are some clinical suggestions of the benefits of the combined use of nedocromil sodium and an inhaled corticosteroid.