NON-CORTICOSTEROID ANTIINFLAMMATORY DRUGS IN ASTHMA - CLINICAL-PHARMACOLOGY AND RECOMMENDATIONS FOR USE

Asthma is a chronic inflammatory disease of the airways, As airways in flammation plays a principal role in the pathogenesis of asthma, even in patients with mild disease, current recommendations give anti-infla mmatory therapy a central position in the treatment of asthma, Althoug h inhaled corticosteroids are the most widely used anti-inflammatory d rugs in the management of patients with asthma, nonsteroidal anti-infl ammatory agents may be used as a first step. Sodium cromoglycate (crom olyn sodium) and nedocromil are anti-inflammatory drugs which are effe ctive in many patients with asthma of mild to moderate severity, Both drugs have been demonstrated to be well tolerated. Nedocromil is more potent than sodium cromoglycate, although the number of clinical studi es that have compared these two drugs is small. Nedocromil may also be effective as a corticosteroid-sparing agent in the treatment of patie nts with asthma who require high dosages of inhaled corticosteroids, T his may be important, as high dosages of inhaled corticosteroids may c ause adverse effects. A novel approach to the treatment of asthma is r epresented by the leukotriene synthesis inhibitors and leukotriene rec eptor antagonists, new classes of anti-inflammatory drugs. Although th e number of clinical studies with these agents is relatively small. th ey indicate effectiveness in the treatment of patients with mild to mo derate asthma with no systemic adverse effects. Theophylline has only recently been reconsidered as a potential anti-inflammatory drug. Alth ough serious toxicity may occur with this agent, theophylline is effec tive in reducing symptoms and improving lung function in patients with mild chronic asthma, even in those already treated with inhaled corti costeroids.