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Inhaled steroids preferred over cromolyn to treat asthma

Adults and children with asthma will breathe deeper and have better control over their asthma with inhaled corticosteroids than with the medicine cromolyn, according to a new review of recent studies comparing the two treatments.

Adult asthma patients using inhaled steroids such as the brand names Beclovent, Pulmicort and Flovent had on average three fewer severe asthma flare-ups each year compared to patients using inhaled cromolyn, sold under the brand name Intal.

Patients taking the steroids also scored significantly higher on tests of lung function and used their "rescue" inhalers less often than those taking cromolyn, say James Guevara, M.D., of the University of Pennsylvania School of Medicine and colleagues.

The findings were similar for children, Guevara and colleagues add, saying that their review supports recent consensus in the medical community that favors inhaled corticosteroids as a first-choice treatment for asthma.

"To our knowledge, this is the first systematic review comparing the effects of cromolyn to the gold standard, inhaled steroids," Guevara said.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The consensus still leaves room for cromolyn treatment, according to William Storms, M.D., an allergist at the University of Colorado Health Sciences Center and director of the William Storms Allergy Clinic in Colorado Springs.

"Any expert would agree that inhaled corticosteroids are preferred first-line therapy for treatment of persistent asthma, which requires daily therapy. But we also will agree with the NIH [National Institutes of Health] asthma guidelines, which state that cromolyn and other drugs are alternati
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Contact: James Guevara
guevara@email.chop.edu
Center for the Advancement of Health
18-Apr-2006


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