Ketotifen in childhood allergic disease.

Abstract

Introduction Attempts to develop an orally active sodium cromoglycate (SCG)-like compound have been as intense and competitive as was the search for the 'Holy Grail'. The development of SCG was the outcome of exhaustive studies of the constituents of Khellin, utilizing challenge tests in human asthma (Cox, 1967). It did not arise from a fundamental understanding of the aetiology of asthma. In many respects the clinical success of SCG in allergic disorders has retarded the development of new drugs for these conditions. Identification of the in vitro mast cell stabilizing properties of SCG led to the assumption that this property accounted for its action (Cox, 1971). Several orally active mast cell stabilizing compounds have been made, but few have achieved clinical success. However, it is now evident that SCG operates by mechanisms other than or in addition to mast cell stabilization (Altounyan, 1980). Clinical experience suggests that SCG is particularly effective in young children, but its use in this age group is limited by the need for administration by inhalation (Geller-Bernstein & Sneh, 1980). Thus an orally absorbed systemically active compound would be valuable in the treatment of childhood asthma, and may also control allergic rhinitis and conjunctivitis. Unfortunately orally administered drugs may not be as effective as those given by inhalation because intra-luminal events, including mast cell degranulation are probably important in the initiation of allergic reactions (Davies & Phillips, 1982).