[Budesonide: efficacy and indications of low posology]

Although inflammation plays a crucial role in asthma, asthma is not equivalent to inflammation. On the one hand, the relationship between the degree of airway inflammation and the level of bronchial responsiveness to pharmacological agents is not well established. On the other hand, even if late asthmatic reactions has many inflammatory characteristics, the response to the inhalation of a beta-2 adrenergic agent is generally good, which suggests some muscular contraction as well in the reduction of airway caliber. The chronic use of antiinflammatory preparations improves the level of bronchial hyperresponsiveness but this effect is not constant, does not generally result in-normal values and may be short-lived after ending the administration of the drug. It is unknown as to whether the chronic use of these preparations: 1) will reduce the mortality and morbidity of asthma; 2) will be devoted of long-term side effects; 3) will be accompanied by a satisfactory compliance. A greater awareness of these potential problems should therefore be kept in mind before prescribing low-dose inhaled steroids.