Is sodium cromoglycate effective in nocturnal asthma?

Nocturnal asthma is potentially dangerous' 2 and may be difficult to treat. Slow release oral preparations of methylxanthines3 or high dose aerosol treatment with /2 stimulants4 have been advocated. In our experience, however, both of these groups of drugs may be quite ineffective in some patients and many patients cannot tolerate methylxanthines in effective doses. The dose of sympathomimetic drugs may be more important than the route of administration.5 The mechanisms underlying nocturnal asthma are poorly understood.6 The most widely accepted view is that it results from the permissive effect on release of mediators from mast cells at night as circulating catecholamine concentrations fall.7 Sodium cromoglycate might therefore be expected to control nocturnal asthma by stabilising mast cells. Moreover, its low toxicity might facilitate the use of proportionally higher doses than can be contemplated with sympathomimetic drugs. We have studied the effects of sodium cromoglycate, in a standard dosage of 80 mg/day and a high dosage of 280 mg/day, versus placebo in patients with nocturnal asthma that was inadequately controlled by sympathomimetic drugs.