[Inhaled corticosteroids and the local effects--a justified fear?]

Inhaled corticosteroids continue to be hallmark players in asthma control. In time, they induced fear, hope, and created numerous discussions in specialty literature. Usually, the studies focus more on their beneficial effects and less on adverse effects. Surprisingly, lately more was written about systemic effects. A detailed review of some recent studies demonstrates that the most feared systemic effects (risk for osteoporosis due to calcium and phosphate metabolic changes, adrenal suppression, skin thinning, cataract, growth problems in children and teenagers, glaucoma) are very rare. The local effects, if properly addressed by the physician and patient, can be largely diminished. The conclusion of this article is that there is a non-due fear for this class of medication with certain virtues in asthma and COPD therapy.