[Inhaled corticotherapy sparing effect by sodium nedocromil in moderate to severe asthma]

Area of Science:

• Respiratory Medicine
• Pharmacology

Background:

• High-dose inhaled steroids for asthma carry risks of dose-dependent side effects.
• Nedocromil sodium is a non-steroidal anti-inflammatory agent.

Purpose of the Study:

• To evaluate the therapeutic benefit of nedocromil sodium in asthma patients using high-dose inhaled steroids.
• To determine if nedocromil sodium can reduce the required dose of inhaled steroids (steroid-sparing effect).

Main Methods:

• 134 adults with moderate to severe asthma inadequately controlled by high-dose inhaled steroids were studied.
• A 24-week double-blind, placebo-controlled trial involved randomization to nedocromil sodium or placebo.
• Inhaled steroid doses were adjusted in the latter 12 weeks based on asthma control scores.

Main Results:

• A significant steroid-sparing effect was observed: 79% of patients on nedocromil sodium achieved a ≥250 mcg decrease in inhaled steroid dose compared to 60% on placebo (p < 0.03).
• Symptom scores improved in both groups, with significantly greater improvement in daytime asthma for the nedocromil sodium group (p < 0.02).
• For patients receiving nedocromil, FEV1 improved significantly (from 69% to 74%; p < 0.005), while no improvement was seen in the placebo group.

Conclusions:

• Nedocromil sodium is effective as an add-on therapy for moderate to severe asthma patients already on high-dose inhaled steroids.
• The study demonstrates a notable steroid-sparing effect for nedocromil sodium in this patient population.