Changes in corticosteroid usage by chronic asthma patients during a year of cromoglycate treatment

Fifteen chronic asthmatic, steroid-dependent subjects were treated for one year with disodium cromoglycate (DSCG) while their previous maintenance steroid dosage was gradually reduced or withdrawn. Twelve asthma indices were monitored concurrently so that the observed steroid dose reduction could be related to the degree of control of the chronic asthma. In view of the characteristically varying course of the disease, the observed changes over the whole year were expressed in terms of average and maximum values. The timing and duration of the study were such as to obviate the influence of seasonally determined improvement trends that otherwise may confound drug-related change. A statistically significant reduction in steroid usage was observed in this group of patients and sustained during the year of cromoglycate treatment. The average reduction of the group over the year was 29 per cent, and the median reduction was 33 per cent. Within the group 11 of 15 reduced steroid usage; 3 who had required maintenance prednisone doses above 15 mg. daily were successfully reduced to lower dosage; 4 were converted to alternate-day therapy and stabilized there, whereas conversion attempts had previously failed; in 2 the maintenance steroid regimen was terminated. The possibility that the reduced steroid requirements might be due to the natural course of the disease rather than to the DSCG treatment cannot be entirely excluded.