This study conducted on 60 chronic asthmatic patients with positive skin test to different antigens to evaluate the efficacy of cromolyn sodium (DSCG) and ketotifen in the treatment of bronchial asthma. All patients were subjected to history taking, ventilatory function tests, metacholine bronchoprovocation challenge test, total and specific IgE and TIPTS ratio. The patients were classified into 3 groups each comprising (20 cases) group A: receiving DSCG, group B, receiving ketonfen and group C; receiving placebo. These drugs were given for 6 months together with oral terbutaline and oral corticosteroids in steroid-dependent asthmatics. Patients were regularly evaluated clinically and by the peak flow meter, and after 6 months of treatment study design was repeated, except specific IgE estimation. There was insignificant reduction in the size of skin test induration in both group A and B. Total IgE was high in the three groups before treatment, however, it was insignificantly reduced in group A and B. There was a significant reduction of TH/TS at the end of treatment in group A only. Group A showed significant improvement in small airway functions more than placebo but no statistically significant difference between group A and B was detected. Bronchial hyperreactivity was significantly reduced only in group A. Cromolyn led to more reduction and cessation of concomitant medications, including steroids, with more subjective improvement when compared with ketotifen. In conclusion, cromolyn provided more subjective benefit, than ketotifen in asthmatics. In addition cromolyn reduced TH/TS, and bronchial hyperreactivity whereas ketotifen did not. Cromolyn improved ventilatory functions mainly small airway an effect was not obtained by ketotifen. Cromolyn allowed more reduction or cessation of concomitant medications, thus providing a measure of freedom from continuing asthma attacks and multiple drug therapy with its potential side effects |