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Inhaled steroid asthma treatment: 'Primum non nocere'
1London Health Sciences Centre, Allergy Clinic, London, Canada.
Canadian Respiratory Journal
|September 30, 1998
Summary
Inhaled steroid therapy for asthma carries dose-dependent risks like thrush and adrenal suppression. Practical strategies can minimize these adverse effects for better patient outcomes.
Area of Science:
- Pulmonology
- Endocrinology
- Ophthalmology
Background:
- Inhaled corticosteroids (ICS) are a cornerstone of asthma management.
- Concerns regarding potential adverse effects of ICS can impede optimal therapy.
- Understanding and mitigating these risks is crucial for patient adherence and treatment efficacy.
Purpose of the Study:
- To review the potential risks associated with antiasthmatic inhaled steroid therapy.
- To discuss practical measures for minimizing these identified risks.
Main Methods:
- Literature review of known complications associated with inhaled corticosteroids.
- Analysis of dose-dependency of identified risks.
- Discussion of risk mitigation strategies.
Main Results:
- Potential risks are primarily dose-related.
- Oropharyngeal complications include thrush and dysphonia.
- Systemic complications encompass hyperactivity, HPA axis suppression, Cushingoid features, cataracts, glaucoma, skin atrophy, growth retardation, and osteoporosis.
- Rarely, fractures and acute adrenal insufficiency have been reported.
Conclusions:
- The risks of inhaled steroid therapy are dose-dependent and manageable.
- Awareness of potential complications and implementation of risk-minimization strategies are essential.
- Effective management of asthma with inhaled steroids can be achieved by balancing benefits against potential risks.
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