Mucosal changes in the airways during long-term corticosteroid treatment

Area of Science:

• Pharmacology
• Respiratory Medicine
• Dermatology

Background:

• Long-term safety data for beclomethasone dipropionate and budesonide in treating rhinitis and asthma are limited.
• Widespread use of beclomethasone dipropionate for 8 years and budesonide for 1 year has shown few local side effects.
• Steroid potency is linked to increased side effect risk in skin studies, but this relationship is unclear for airway steroids.

Purpose of the Study:

• To assess the potential risks and side effects of beclomethasone dipropionate and budesonide used in long-term airway treatments.
• To investigate whether the safety profile of beclomethasone dipropionate extends to budesonide, considering potential differences in potency.
• To highlight the suitability of nasal airway mucosa for studying local steroid effects.

Main Methods:

• Review of existing long-term animal and human studies on beclomethasone dipropionate and budesonide.
• Comparison of local side effect profiles between the two corticosteroids.
• Consideration of steroid potency in relation to observed side effects.

Main Results:

• Remarkably few local side effects have been observed with both beclomethasone dipropionate and budesonide.
• The safety profile of beclomethasone dipropionate suggests a low risk of serious local side effects.
• The extent to which budesonide's safety mirrors beclomethasone dipropionate's is not fully established due to potential potency differences.

Conclusions:

• Long-term studies on budesonide are warranted to fully understand its safety profile in airway treatments.
• Nasal airway mucosa offers an accessible and relevant model for studying local corticosteroid effects.
• Current evidence suggests a favorable safety profile for both beclomethasone dipropionate and budesonide in respiratory conditions.