International and Japanese guidelines classify childhood
asthma as mild, moderate, or severe, and recommend treatment with "as needed"
bronchodilators, inhaled
sodium cromoglycate, and inhaled
corticosteroids, respectively. Alternatively, some investigators proposed inhaled
corticosteroids as first-line
therapy to prevent airway inflammatory obstruction. This article describes a clinical study assessing the effect of early intervention with inhaled
sodium cromoglycate in childhood
asthma. This was a retrospective study of 189 asthmatic children treated with inhaled
sodium cromoglycate for five years and whose age of onset of
asthma was six year of age or younger. An end-of-study questionnaire completed the examination. Children administered oral or inhaled
corticosteroids simultaneously with
sodium cromoglycate, were excluded.
Asthma scores as defined by the Japanese Pediatric Allergic Committee, were reduced continuously during the five years after the start of
sodium cromoglycate treatment. The frequency of emergency department visits and hospitalizations also decreased. Significant between-period intervention differences showed improvement of clinical outcomes for children with severe
asthma during the five years of
sodium cromoglycate inhalation. The early intervention regime of starting
sodium cromoglycate inhalation within two years of the onset of
asthma shows a large improvement in the long-term prognosis of childhood
asthma, especially for children with severe
asthma. It is possible that starting inhaled
sodium cromoglycate earlier than the present recommendation of
corticosteroids could further improve clinical outcomes, but a prospective study should be performed to verify our results.