The use of inhaled corticosteroids in asthma

Inhaled corticosteroids are the most important therapeutic agents for the pharmacological control of pulmonary inflammation in asthma. There is concern, however, about the occurrence of side effects with the long-term use of inhaled corticosteroids. Because of the potential seriousness of some of these side effects, patients should be monitored carefully and preventively treated for the side effects. Various noncorticosteroid medications have been recommended in guidelines as substitutes for inhaled corticosteroids for daily use as long-term controllers in asthma, e.g., sustained-release theophylline, long-acting beta-agonists, leukotriene modifiers, cromolyn, and nedocromil. However, of the long-term controller medications recommended in the guidelines, only inhaled corticosteroids have to date, been shown clinically to reduce asthma fatalities and to prevent asthma induced lung remodeling.