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Long-term trial of disodium cromoglycate and isoprenaline in children with asthma
Insights
Disodium cromoglycate effectively controlled severe perennial asthma in children. Premedication with disodium cromoglycate prevented exercise-induced asthma and correlated with positive clinical responses.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Clinical Pharmacology
Background:
- Severe perennial asthma in children often requires effective long-term management.
- Current treatment options may have limitations or side effects, necessitating alternative therapies.
- Exercise-induced asthma is a common and challenging symptom in pediatric asthma patients.
Purpose of the Study:
- To evaluate the efficacy and safety of disodium cromoglycate with isoprenaline in managing severe perennial asthma in children.
- To assess the drug's impact on symptom control, treatment adherence, and exercise-induced asthma.
- To explore potential predictors of treatment response in pediatric asthma patients.
Main Methods:
- A year-long, double-blind, placebo-controlled trial involving 53 children with severe perennial asthma.
- Participants received either disodium cromoglycate with isoprenaline or lactose with isoprenaline (placebo) four times daily.
- Evaluation included daily diaries, clinical assessments, physiological measurements, and laboratory exercise tests.
Main Results:
- After one year, 71% of the treatment group maintained good symptom control, compared to a high dropout rate (76%) in the placebo group due to inadequate control.
- No significant increase in failure rates or seasonal variations were observed.
- Prevention of exercise-induced asthma via premedication with disodium cromoglycate correlated strongly with satisfactory clinical outcomes.
Conclusions:
- Disodium cromoglycate with isoprenaline offers effective and well-tolerated long-term control for severe perennial asthma in children.
- The drug's ability to prevent exercise-induced asthma is a reliable indicator of clinical treatment success.
- Predicting treatment outcomes based on initial clinical, physiological, or immunological status was not feasible.
Abstract:
A year-long double-blind trial was carried out in 53 asthmatic children with severe perennial symptoms who were not receiving corticosteroids or corticotrophin. The treatment group were given disodium cromoglycate with isoprenaline (Intal Co.) while the placebo group were given lactose with isoprenaline four times daily. The groups were closely matched for clinical, physiological, and immunological features. Evaluation was based on the use of a diary and clinical and physiological investigations, including exercise tests.After one year 71% of the treatment group were still well controlled while 76% of the placebo group had dropped out because of inadequate control of symptoms. There was no rise in the rate of failure towards the end of the trial period and there were no seasonal variations in the failure rate. No important toxic effects were noted. It was impossible to predict the outcome of the trial in any given patient from his clinical, physiological, or immunological status at the beginning. However, the prevention of exercise-induced asthma by premedication with disodium cromoglycate in a laboratory exercise test did correlate well with the satisfactory clinical response to the drug.