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(Chest. 1999;116:65-72.)
© 1999 American College of Chest Physicians

Controlled Trial of Two Formulations of Cromolyn Sodium in the Treatment of Asthmatic Patients >= 12 Years of Age*

Clifton Furukawa, MD; Dean Atkinson, MD; Terrence J. Forster, MD; Kristine Nazzario, RPh; Brandon Simpson; Thomas Uryniak, MS; Frank E. Casty, MD, FCCP and for the Intal Study Group

* From the Department of Pediatrics (Dr. Furukawa), University of Washington, School of Medicine, Seattle, WA; Oklahoma Allergy and Asthma Clinic (Dr. Atkinson), Oklahoma City, OK; Allergy, Asthma and Arthritis Associates, P.C. (Dr. Forster), Doylestown, PA; and Rhône-Poulenc Rorer (Ms. Nazzario, Messrs. Simpson and Uryniak, and Dr. Casty), Collegeville, PA.

Correspondence to: Frank E. Casty, MD, FCCP, 324 Glad Way, Collegeville, PA 19426; e-mail: frank.casty{at}rp-rorer.com

Study objectives: This multicenter, randomized, double-blind, placebo-controlled, parallel study compared the efficacy and safety of the hydrofluoroalkane (HFA) formulation of cromolyn sodium metered-dose inhaler (MDI) with the chlorofluorocarbon (CFC) formulation in asthmatic patients >= 12 years old over a 12-week period.

Design: Stable asthmatics using only currently marketed cromolyn sodium and as-needed inhaled ß2-agonists were randomly assigned to treatment with HFA cromolyn sodium, CFC cromolyn sodium, or placebo, administered as two inhalations (2 mg) qid for 12 weeks. Prior to randomization, all patients were required to meet minimum symptom and/or pulmonary function test criteria after discontinuation of cromolyn sodium. Efficacy was assessed by changes in daily symptom scores, albuterol use, peak expiratory flow, pulmonary function measurements, and overall opinions of effectiveness.

Results: A total of 280 patients in 29 centers were randomly assigned to treatment with HFA cromolyn sodium (n = 94), CFC cromolyn sodium (n = 91), or placebo (n = 95). Patients treated with the HFA formulation of cromolyn sodium demonstrated a 28 to 33% improvement over placebo for all symptom scores (p < 0.05) and a 35% improvement over placebo in the use of albuterol MDI (p < 0.05). The patients' opinions of overall effectiveness favored HFA cromolyn sodium (p = 0.011) and CFC cromolyn sodium (p = 0.006) over placebo. The investigators' opinions indicated a statistically significant difference favoring CFC cromolyn sodium compared with both placebo (p < 0.001) and HFA cromolyn sodium (p = 0.042). No statistically significant differences existed among groups in the incidence of treatment-related adverse events.

Conclusion: The HFA formulation of cromolyn sodium MDI is a well-tolerated and effective treatment for asthma patients >= 12 years old. The safety and efficacy profile of the HFA formulation is comparable to that of the CFC formulation.

Key Words: chlorofluorocarbon • cromolyn sodium • hydrofluoroalkane • metered-dose inhaler • Montreal Protocol • ozone






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