Am. J. Respir. Crit. Care Med., Volume 161, Number 6, June 2000, 2096-2099

Nedocromil Sodium Inhibits Responsiveness to Inhaled Mannitol in Asthmatic Subjects

JOHN D. BRANNAN, SANDRA D. ANDERSON, RUTH FREED, JOERG D. LEUPPI, HEIKKI KOSKELA, and HAK-KIM CHAN

Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, Australia; Institute of Respiratory Medicine, Department of Pharmacy, and Department of Pharmacology, University of Sydney, Sydney, Australia; and Department of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland

Nedocromil sodium inhibits the response to exercise-induced asthma (EIA). Mannitol given as a powder by inhalation is an osmotic stimulus that identifies EIA. We studied the acute effect of nedocromil on airway responsiveness to mannitol in 24 asthmatic subjects. After a control day, nedocromil (8 mg) or its placebo was administered randomized, double blind, 10 min before a challenge with progressively increasing doses of mannitol. Nedocromil inhibited the response to mannitol and there was a significant increase in the dose of mannitol required to cause a 15% reduction in FEV₁ (PD₁₅) after nedocromil 409 (316,503) mg compared with placebo 156 (106,229) mg (p < 0.001). In the presence of nedocromil 12 subjects no longer recorded a 15% decrease in FEV₁ in response to mannitol. The remaining 12 required a significantly greater dose of mannitol to achieve a 15% decrease in FEV₁ after nedocromil. Following nedocromil, a plateau in responsiveness to mannitol was observed in 14 subjects. Nedocromil significantly inhibits the responsiveness to inhaled mannitol in asthmatic subjects.

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