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[Primum non nocere...inhaled glucocorticosteroids in 2003]
1Service de Pneumologie (Pr Dusser), Hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris. Jacques.lacronique@cch.ap-hop-paris.fr
Revue De Pneumologie Clinique
|September 18, 2003
Summary
Inhaled glucocorticoids for asthma are generally safe, but long-term low-dose effects require more study. Benefit-risk assessment is key for developing effective asthma treatments.
Area of Science:
- Pharmacology
- Respiratory Medicine
- Clinical Therapeutics
Context:
- Inhaled glucocorticosteroids (ICS) are a cornerstone in asthma management.
- Assessing the benefit-risk ratio of ICS is crucial for developing safer and more effective treatments.
- Factors influencing ICS efficacy and safety include topical activity, systemic bioavailability, and patient-specific variables.
Purpose:
- To evaluate the short- and long-term safety of inhaled glucocorticosteroids for asthma.
- To understand the factors influencing the therapeutic index of ICS.
- To identify potential risks associated with high-dose and long-term low-dose ICS use.
Summary:
- Optimal ICS profiles depend on topical activity, systemic bioavailability, and pharmacokinetics.
- High-dose ICS may transiently affect adrenal function and bone growth in children, with no impact on final height.
- Adults using ICS may face osteoporosis risks, necessitating monitoring and prevention, while ocular risks require further investigation.
Impact:
- While significant adverse systemic effects are uncommon with ICS, long-term safety data, especially for low-dose administration, needs further research.
- Understanding these factors allows for personalized treatment strategies to maximize therapeutic benefits while minimizing risks.
- This research informs the development of next-generation inhaled corticosteroids with improved safety profiles for asthma patients.