SELECTED ARTICLES FROM THE RECENT LITERATURE 2006

11/17/06

Dose-dependent effects of inhaled corticosteroids in asthma

Summary
Background - There have been inconsistent findings whether the beneficial effects of inhaled corticosteroids (ICS) ytrsymrny in asthma are clearly dose dependent.

Findings - Mikhak of the Massachusetts General Hospital in Boston, MS reviewed the literature to determine whether the degree of baseline severity was a significant predictor of whether there would be a dose-dependent beneficial effect in asthma of treatment with 2 commonly used ICS agents, - fluticasone (FP) and budesonide (Bud). The authors identified 29 articles studying FP and 32 articles investigating Bud that met their entrance criteria. They noted considerable variability among these studies in the assessment and reporting of baseline severity of the study patients. This variation led to a heterogeneity in the findings reported. However, a dose-dependent effect of the ICS treatment was rather consistent when the baseline severity of the asthma was of a degree so that the patients were taking oral steroid therapy.

Reference
Allergy Asthma Proc 2006;27:402-11

Editor's Comments
Many investigators have concluded that dose-dependent beneficial effects of ICS in asthma tend to plateau at doses above 800-1000 mcg/day for an average sized adult. However, adverse effects of ICS continue to increase in frequency and degree at doses above 800 mcg/day.

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