Cromolyn versus triamcinolone acetonide for youngsters with moderate asthma

• Published in: Journal of allergy and clinical immunology Vol. 88; no. 5; pp. 742 - 748
• Main Authors: Shapiro, Gail G., Sharpe, Marian, DeRouen, Timothy A., Pierson, William E., Furukawa, Clifton T., Virant, Frank S., Bierman, C.Warren
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.11.1991; Elsevier
• Subjects: Administration, Inhalation; Adolescent; Asthma - drug therapy; Asthma - physiopathology; Biological and medical sciences; Bronchial Provocation Tests; Child; childhood asthma; Chronic obstructive pulmonary disease, asthma; Cromolyn; Cromolyn Sodium - therapeutic use; Double-Blind Method; Female; Forced Expiratory Volume; Humans; inhaled steroids; Male; Medical sciences; Peak Expiratory Flow Rate; Pneumology; Respiratory Function Tests; Treatment Outcome; triamcinolone; Triamcinolone Acetonide - therapeutic use; inhaled steroids; childhood asthma; Cromolyn; triamcinolone; Human; Corticosteroid; Chemotherapy; Treatment; Respiratory disease; Adolescent; Child; Comparative study; Asthma
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/0091-6749(91)90181-M

Although both cromolyn (C) and inhaled corticosteroids are anti-inflammatory therapies for childhood asthma, there are few controlled comparisons of these medications for asthma therapy in children. None were conducted in the United States, and none specifically study triamcinolone acetonide (T) versus C. This 12-week evaluation followed 31 youths, aged 8 to 18 years, with moderate asthma who were assigned to receive C or T according to a prerandomized and blinded code. Patients were instructed to take two inhalations from the study metered-dose inhaler (active T or placebo) and to inhale the contents of one study-provided ampule (C, 20 mg, or placebo) from a compressor-driven home nebulizer three times per day. Patients also used albuterol, two inhalations from a metered-dose inhaler, three times a day (before study medication) and, additionally, if needed. Patients maintained a daily diary, recording extra medication use, adverse experiences, peak flow rates morning and night, and asthma symptom scores. Laboratory assessment of pulmonary function was done at 1, 4, 8, and 12 weeks. Cosyntropin challenge and methacholine bronchoprovocation challenge were performed at the beginning and end of the study. C and T provided similar, adequate asthma control. Symptoms of wheezing, cough, and chest tightness decreased, and daily peak expiratory flow rate increased with both regimens compared to during a 2-week baseline when patients received medication only as needed. There was no significant change in methacholine sensitivity and no change in endocrine function, as measured with fasting plasma control before and after administration of cosyntropin. Although there were significant intragroup differences in the T- but not C-treated groups, there were no discernible significant differences between C and T at these dosages.