Attenuation of Aspirin-induced Bronchoconstrldlon by Sodium Cromoglycate and Nedocromll Sodium

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 ac­ tivity against aspirin-induced bronchoconstriction. Ten patients with aspirin-induced asthma under­ went three bronchial challenges with a single dose of lysine acetylsalicylate (LASA) that caused a de­ crease 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 SRawwere recorded at inter­ vals 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. Robuschl M, Gambaro C, Sestlnl P, Pieroni MG, Reflnl RM,Vaghl A, Blanco S. Attenuation of aspirin-Induced bronchoconstrldlon by sodium cromo­ glycate and nedocromll sodium. AM J RESPtRCRIT CARE MED 1997;155:1461-1464.