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Ciclesonide: a novel inhaled corticosteroid for asthma.
1Division of Allergy, University of Washington, Seattle, Washington, USA. pchristi@u.washington.edu
Drugs of Today (Barcelona, Spain : 1998)
|October 29, 2004
Summary
Ciclesonide, an inhaled corticosteroid, effectively controls asthma symptoms and improves lung function. It offers a favorable safety profile with reduced systemic exposure compared to other inhaled corticosteroids.
Area of Science:
- Pulmonology
- Pharmacology
Background:
- Inhaled corticosteroids (ICS) are standard asthma treatment, improving symptoms and reducing exacerbations.
- Concerns exist regarding ICS side effects, including local (dysphonia, candidiasis) and systemic (cortisol suppression, bone density loss) issues.
- Dose and duration of ICS therapy correlate with increased risk of adverse effects.
Purpose of the Study:
- To evaluate ciclesonide, a novel ICS, for its efficacy and safety in asthma management.
- To assess the pharmacokinetic profile of ciclesonide, focusing on local activation and systemic exposure.
Main Methods:
- Ciclesonide is a prodrug converted to its active metabolite, desisobutyryl-ciclesonide (des-CIC), in the airways.
- Des-CIC exhibits high glucocorticoid receptor binding affinity.
- Ciclesonide is administered via a hydrofluoroalkane metered-dose inhaler (MDI) for once-daily dosing.
Main Results:
- Ciclesonide demonstrated efficacy comparable to existing gold-standard ICS.
- The active metabolite, des-CIC, has significantly higher receptor affinity than the parent compound.
- Systemic exposure to ciclesonide is minimized due to high protein binding and rapid metabolism.
Conclusions:
- Ciclesonide provides effective asthma control with a favorable safety profile.
- Its local activation and pharmacokinetic properties contribute to reduced systemic side effects.
- Ciclesonide represents a valuable therapeutic option for asthma patients, enhancing compliance through once-daily administration.