Cromones

The cromones are a group of structurally related compounds which inhibit inflammation in a number of allergen-mediated diseases including:

• asthma
• allergic rhinitis
• allergic conjunctivitis
• food allergy

Cromones inhibit the early inflammatory response to allergen by stabilising mast cells. In asthma, the late response of airways hyper-responsiveness is also inhibited, probably by an action on macrophages and eosinophils. Bronchoconstriction caused by irritants such as sulphur dioxide is inhibited by an action on sensory nerves.

Cromones reduce the incidence of asthma atacks and may allow a reduction in the dose of inhaled beta-2 agonists and oral corticosteroids; although the cromones are less effective than inhaled corticosteroids they probably cause fewer long-term side-effects.

Withdrawal of sodium cromoglicate inhaler in the UK (1):

• the asthma preventer inhaler Intal (sodium cromoglicate) is being discontinued, with stock expected to be exhausted by the end of January 2022
• the BTS/SIGN asthma guideline considers inhaled corticosteroids to be the first-choice preventer drug, and sodium cromoglicate as an alternative but less effective preventer therapy
• the Global Initiative for Asthma (GINA) does not recommend the use of chromones in children age 6-11 years because of low efficacy, and does not include this class of agent as a treatment option in adults

Reference:

• NHS. Medicine Supply Notification(8/11/2021) - Sodium cromoglicate (Intal (R)) CFC-free 5mg inhaler