LONG-LASTING TREATMENT WITH CROMONES IN MILD PERSISTENT OR INTERMITTENT ASTHMA IN CHILDREN

L.Fasce, *MG.Calevo, F.Ventura, G.Pulvirenti, A.Molgora, C.Iorio, A.Gazzolo, S.Cozzani.

Department of Pediatrics, University of Genoa-Italy

*Scientific Direction, G. Gaslini Institute, Genoa - Italy

The latest international guidelines for the management of pediatric mild persistent asthma, recommend the use of cromons besides inhaled steroids. Recently, it has been suggested that therapy is able to change the natural course of unstable asthma. This hypotesis is based on the antiinflammatory activity of cromons (even if not so strong as steroids) and on the absence of important side effects even during long-term therapy. In order to verify the effects of long term therapy with cromons in children we studied 102 pediatric patients (pz.) with intermittent or mild persistent asthma. All the pz. had received regular therapy with cromons for at least 1 year and almost all pz. had received topic glucocorticoids for 30-40 days in 1 year. On average, at the beginning of therapy the pz. were 8 years old (range 2-14) and treatment had lasted 32 months (range 12-118). For each pz. the following parameters recorded both in the year before therapy with cromons and in the year before the last control were considered: frequency of acute episodes, severity of the acute episodes, overnight symptoms, exercise-induced symptoms.

A significant difference (p< 0.01) in the frequency of episodes before and after therapy was demonstrated. In fact the number of pz. with 1-4 episodes/year increased from 51 to 68, the number of pz. with 5-10 episodes/year decreased from 43 to 5 and only 1 pz. out of 7 continued to present more than 10 episodes /year. 28 pz. had no more acute episodes. In the 74 pz. still presenting acute episodes after therapy, the episodes were less severe. In particular, the number of pz. with mild episodes increased from 46 to 65; the number of pz. with moderate episodes decreased from 50 to 9. No pz. had more severe episodes. Overnight symptoms were observed in 6 pz. before therapy and only in 3 pz. after. Following treatment improvement or total disappearance of exercise-induced symptoms were observed. In fact the number of pz. without these symptoms increased from 41 to 63, the number of pz. with occasional symptoms from 80 to 33, the number of pz. with costant symptoms decreased from 41 to 6.

Conclusions: after a proper and long-lasting therapy with cromons, an improvement in all parameters considered was observed until the end of symptoms in some pz..