Inhaled nonsteroidal anti-inflammatory medications in the treatment of asthma.
Asthma is characterized by airway inflammation even in the mildest cases. Multiple studies have confirmed evidence of significant elevations of inflammatory cells and mediators even at baseline in the airway of asthmatics. Cromolyn sodium (SCG) and nedocromil sodium (NS), the "nonsteroidal anti-inflammatory agents" are considered options for the management of mild persistent asthma in both adults and children as outlined by the Global Initiative for Asthma and the Expert Panel II, National Asthma Education and Prevention Program 1997 guidelines. These drugs may inhibit both the early and late asthmatic response, ostensibly by stabilizing mast cells and by reducing the total number of eosinophils and their recruitment. SCG and NS have extremely safe profiles, making them attractive for use even in young children. In addition to daily use for mild persistent asthma, SCG and NS are effective inhibitors of exercise-induced bronchospasm (EIB). Although these drugs are unlikely to eliminate the use of inhaled corticosteroids in patients with more significant obstructive airway disease, they have potentially beneficial steroid-sparing effects. Thus, the cromione, SCG and NS, are effective prophylactic drugs recommended for use in both adults and children in the management of mild persistent asthma, EIB, and potentially as modest steroid-sparing agents.
Krawiec
M E
ME
Department of Pediatrics, University of Colorado Health Sciences Center, Denver 80218, USA. krwiecm@njc.org
Wenzel
S E
SE
D000280:Administration, Inhalation; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001249:Asthma / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control; D001250:Asthma, Exercise-Induced / Q000517:prevention & control; D002465:Cell Movement / Q000187:drug effects; D002648:Child; D004205:Cromolyn Sodium / Q000627:therapeutic use; D004804:Eosinophils / Q000187:drug effects; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis; D007958:Leukocyte Count / Q000187:drug effects; D008407:Mast Cells / Q000187:drug effects; D017835:Nedocromil / Q000627:therapeutic use
D018927:Anti-Asthmatic Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018836:Inflammation Mediators; D017835:Nedocromil; D004205:Cromolyn Sodium