Am. J. Respir. Crit. Care Med., Vol 155, No. 4, Apr 1997, 1461-1464.
Attenuation of aspirin-induced bronchoconstriction by sodium cromoglycate and nedocromil sodium
M Robuschi, G Gambaro, P Sestini, MG Pieroni, RM Refini, A Vaghi and S Bianco
Institute of Respiratory Diseases, University of Milan, Italy.
The protective activity of nedocromil sodium and of sodium cromoglycate
against aspirin-induced asthma has never been investigated in controlled
studies. Because it has been reported that aspirin-induced
platelet-mediated cytotoxic activity in vitro is inhibited after treatment
in vivo with nedocromil but not with cromoglycate, we investigated whether
these compounds also exhibit a different protective activity against
aspirin-induced bronchoconstriction. Ten patients with aspirin-induced
asthma underwent three bronchial challenges with a single dose of lysine
acetylsalicylate (LASA) that caused a decrease in FEV1 of 25% or more in a
preliminary dose-response test 30 min after inhalation of 4 mg nedocromil
sodium, 10 mg sodium cromoglycate, or placebo. FEV1 and SRaw were recorded
at intervals for 195 min. After placebo, LASA caused a maximal decrease in
FEV1 of 42 +/- 4% of baseline. After cromoglycate and nedocromil the
maximal decrease in FEV1 was reduced to 20 +/- 3% and 18 +/- 4%,
respectively (p < 0.01 versus placebo for both treatments), without
significant differences between the two treatments. Similar results were
observed with SRaw. We conclude that, at the recommended therapeutic doses,
sodium cromoglycate and nedocromil sodium are equally effective in
attenuating aspirin-induced bronchoconstriction and that it is unlikely
that platelet activation participates in the pathogenesis of
aspirin-induced asthma.
