Inhaled corticosteroids in lung diseases.

Area of Science:

• Pulmonology
• Pharmacology
• Clinical Medicine

Background:

• Inhaled corticosteroids (ICSs) are widely prescribed for asthma and chronic obstructive pulmonary disease (COPD).
• These agents possess significant anti-inflammatory properties beneficial for respiratory conditions.
• Their efficacy and safety profile vary among different formulations and patient populations.

Purpose of the Study:

• To review the efficacy and safety of inhaled corticosteroids (ICSs) in managing asthma and COPD.
• To compare the benefits and risks of ICSs across different age groups and disease severities.
• To discuss the current role and future prospects of ICSs in respiratory pharmacotherapy.

Main Methods:

• Systematic review of existing literature on ICS use in asthma and COPD.
• Analysis of clinical trial data and observational studies.
• Evaluation of pharmacokinetic and pharmacodynamic properties of various ICS medications.

Main Results:

• ICSs improve lung function, symptoms, and quality of life, and reduce exacerbations in both asthma and COPD.
• ICSs decrease mortality in asthma but not in COPD.
• Younger children may face higher risks of systemic adverse effects due to higher mg/kg dosing.
• Benefits plateau at low to medium doses, with minimal additional gains at higher doses.
• The role of ICSs in COPD is more debated than in asthma.

Conclusions:

• ICSs remain a cornerstone therapy for persistent asthma across all ages.
• Their utility in COPD management is less established and warrants careful consideration.
• While new treatments are emerging, ICSs are likely to remain the preferred initial long-term controller for asthma.
• Further development of effective initial controller therapies for COPD is needed.