[Inhaled corticotherapy in asthma: when should it be started and how to stop?]

Bronchial inflammation is an almost constantly encountered feature in asthma, even in early stages. Corticosteroid therapy has been shown to be effective both in reducing bronchial inflammation and improving signs of bronchial hyperreactivity. The possible side effects of prolonged inhaled corticosteroids cannot be ignored. Thus, while the indication for inhaled corticosteroids is severe asthma is clear, many questions are raised in case of intermittent minor asthma. There is still much debate over the correct initial dose (high or low) and the clinical and functional criteria for dose reduction or withdrawal. We discuss here the modalities for starting and stopping inhaled corticosteroids in patients with asthma.