A Cochrane review (abstract , review [Abstract]) included 24 studies with a total of 518 patients. Compared to anti-cholinergic agents (AC: ipratoropium, oxytropium, or atropine), mast cell stabilisers (MCS: nedocromil and cromoglycate) were somewhat more effective at attenuating bronchoconstriction. On average the maximum fall on MCS was reduced to 7.1% compared to 13.8% on AC ( WMD = 6.7%; 95% CI: 3.3 to 10.0), provided more individuals with complete protection (73% vs 56%; OR = 2.2; 95% CI: 1.3 to 3.7). Short acting beta-agonists were more effective than mast-cell stabilizers at preventing deterioration. On average the maximum fall on MCS was 11.2% compared to 4.3% on beta agonists ( WMD = 6.8%; 95% CI: 4.5 to 9.2). MCS provided fewer individuals with complete protection (66% vs 85%; OR = 0.3; 95% CI: 0.2 to 0.5) or clinical protection (55% vs 77%; OR = 0.4; 95% CI: 0.2 to 0.8). 11% of short acting beta-agonist patients experienced side effects compared to 3% of those receiving mast cell stabilisers (OR = 0.2; 95% CI: 0.0 to 8.2). Combining mast cell stabilisers with a short acting beta-agonist did not produce significant advantages to pulmonary function over short acting beta-agonists alone. On average the maximum fall on SABA only was reduced to 5.3% compared to 3.5% on the combination ( WMD = 1.8%; 95% CI: -1.1 to 4.6).
Another Cochrane review (abstract , review [Abstract]) included 9 studies with a total of 162 participants. No significant differences existed between nedocromil sodium and sodium cromoglycate with respect to maximum percent fall in FEV1, complete protection, or clinical protection.
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