SAFETY OF INHALED CORTICOSTEROIDS IN THE THERAPY OF BRONCHIAL ASTHMA
https://doi.org/10.18093/0869-0189-2014-0-3-113-120
Abstract
Inhaled corticosteroids (ICS) are the basic medication providing long-term control of asthma. They have a significant antiinflammatory effect leading to decreased mortality, improved lung function, relief of symptoms, reduced exacerbation rate and improved quality of life. Different ICS molecules have different therapeutic index but they act equally in equipotent doses. The maximal effect of ICS is generally seen even in mild to moderate doses which are preferable for regular treatment. Adequate use of mild to moderate doses of ICS is typically accompanied by lower rate of adverse events but the risk of adverse events increase as the dose increase.
Pharmacokinetic properties and mechanism of ICS action, potential systemic and local adverse events and ways to prevent their occurrence have been described in the article.
Pharmacokinetic properties and mechanism of ICS action, potential systemic and local adverse events and ways to prevent their occurrence have been described in the article.
About the Author
N. M. Nenasheva
State Institution Russian Medical Postgradual Academy, the Health Ministry of Russia; Moscow, Russia
Russian Federation
Russian Federation
References
1. Controlled trial of effects of cortisone acetate in status asthmaticus; report to the Medical Research Council by the subcommittee on clinical trials in asthma. Lancet. 1956; 271 (6947): 803–806.
2. Clark T.J. Effect of beclomethasone dipropionate delivered by aerosol in patients with asthma. Lancet. 1972; 1 (7765): 1361–1364.
3. Barnes P.J. Glucocorticosteroids: current and future directions. Br. J. Pharmacol. 2011; 163: 29–43.
4. Schacke H., Schottelius A., Docke W.D. et al. Dissociation of transactivation from transrepression by a selective glucocorticoid receptor agonist leads to separation of therapeutic effects from side effects. Proc. Natl. Acad. Sci. USA. 2004; 101: 227–232.
5. Derendorf H., Nave R., Drollman A. et al. Relevance of pharmacokinetics and pharmacodynamics of inhaled corticosteroids to asthma. Eur. Respir. J. 2006; 28: 1042–1050.
6. Stoloff S.W., Kelly H.W. Updates on the use of inhaled corticosteroids in asthma. Curr. Opin. Allergy Clin. Immunol. 2011; 11 (4): 337–344.
7. Чучалин А.Г., Айсанов З.Р., Белевский А.С. и др. Федеральные клинические рекомендации по диагностике и лечению бронхиальной астмы. Пульмонология. 2014; 2: 11–32. / Chuchalin A.G., Aysanov Z.R., Belevskiy A.S. et al. Federal guidelines for the diagnosis and treatment bronchial asthma. Pul'monologiya. 2014; 2: 11–32 (in Russian).
8. Barnes P.J., Pedersen S., Busse W.W. Efficacy and safety of inhaled corticosteroids. New developments. Am. J. Respir. Crit. Care Med. 1998; 157: S1–S53.
9. Buhl R. Local oropharyngeal side effects of inhaled corticosteroids in patients with asthma. Allergy. 2006; 61: 518–526.
10. Roland N.J., Bhalla R.K., Earis J. The local side effects of inhaled corticosteroids: current understanding and review of the literature. Chest. 2004; 126: 213–219.
11. Selroos O., Backman R., Forsen K.O. et al. Local side-effects during 4-year treatment with inhaled corticosteroids – a comparison between pressurized metered-dose inhalers and Turbuhaler. Allergy. 1994; 49: 888–890.
12. Rachelefsky G.S., Liao Y., Faruqi R. Impact of inhaled corticosteroid-induced oropharyngeal adverse events: results from a meta-analysis. Ann. Allergy Asthma Immunol. 2007; 98 (3): 225–238.
13. Leach C.L., Davidson P.J., Hasselquist B.E., Boudreau R.J. Lung deposition of hydrofluoroalkane-134a beclomethasone is greater than that of chlorofluorocarbon fluticasone and chlorofluorocarbon beclomethasone: a cross-over study in healthy volunteers. Chest. 2002; 122: 510–516.
14. Acerbi D., Brambilla G., Kottakis I. Advances in asthma and COPD management: delivering CFC-free inhaled therapy using Modulite technology. Pulm. Pharmacol. Ther. 2007; 20 (3): 290–303.
15. Huchon G., Magnussen H., Chuchalin A. et al. Lung function and asthma control with beclomethasone and formoterol in single inhaler. Respir. Med. 2009; 103: 41–49.
16. Gabrio B.J., Stein S.W., Velasquez D.J. A newmethod to evaluate plume characteristics of hydrofluoroalkane and chlorofluorocarbon metered dose inhalers. Intern. J. Pharm. 1999; 186 (1): 3–12.
17. Lavorini F., Fontana G.A. Targeting drugs to the airways: the role of spaser devices. Exp. Opin. Drug Deliv. 2009; 6 (1): 91–102.
18. Newman S.P., Weisz A.W., Talaee N., Clarke S.W. Improvement of drug delivery with a breath actuated pressurized aerosol for patients with poor inhaler technique. Thorax. 1991; 46: 712–716.
19. Ahmet A., Kim H., Spie S. Adrenal suppression: A practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy. Allergy Asthma Clin. Immunol. 2011, 7: 13. DOI: 10.1186/1710-1492-7-13.
20. Buehring B., Viswanathan R., Binkley N., Busse W. Glucocorticoid-induced osteoporosis: An update on effects and management. J. Allergy Clin. Immunol. 2013; 132: 1019–1030.
21. Ferguson A.C., Van Bever H.P., Teper A.M. et al. A comparison of the relative growth velocities with budesonide and fluticasone propionate in children with asthma. Respir. Med. 2007; 101: 118–129.
22. Pedersen S., Warner J., Wahn U. et al. Growth, systemic safety, and efficacy during 1 year of asthma treatment with different beclomethasone dipropionate formulations: an open-label, randomized comparison of extrafine and conventional aerosols in children. Pediatrics. 2002; 109: e92.
23. Sharek P.J., Bergman D.A. The effect of inhaled steroids on the linear growth of children with asthma: a meta-analysis. Pediatrics. 2000; 106: E8.
24. The Childhood Asthma Management Program Research Group. Long-term effects of budesonide or nedocromil in children with asthma. N. Engl. J. Med. 2000; 343: 1054–1063.
25. Kelly H.W., Nelson H.S. Potential adverse effects of the inhaled corticosteroids. Allergy Clin. Immunol. 2003; 112 (3): 469–478.
26. Lipworth B.J. Systemic adverse effects of inhaled corticosteroid therapy: a systematic review and meta-analysis. Arch. Intern. Med. 1999, 159: 941–955.
27. Bousquet J., Meziane H., Chanez P. et al. The response of two different dosages of beclometasone dipropionate suspension for nebulization versus a standard dose of beclometasone dipropionate via a metered-dose inhaler on bronchoprovocation testing in adults with asthma. Respir. Med. 2003; 97 (Suppl. B): S11–S14.
28. Thompson P.J., Davies R.J., Young W.F. et al. Safety of hydrofluoroalkane-134a beclomethasone dipropionate extrafine aerosol. Respir. Med. 1998; 92 (Suppl. A): 33–39.
29. Bousquet J., Poli G., Acerbi D. et al. Systemic exposure and implications for lung deposition with an extra-fine hydrofluoroalkane beclometasone dipropionate / formoterol fixed combination. Clin. Pharmacokinet. 2009; 48 (6): 347–358.
30. Kelly H.W. Comparison of inhaled corticosteroids: An update. Ann. Pharmacother. 2009; 43 (3): 519–527.
31. Jones A., Fay J.K., Burr M. et al. Inhaled corticosteroid effects on bone metabolism in asthma and mild chronic obstructive pulmonary disease. Cochrane Database Syst. Rev. 2002; (1): CD003537.
32. Packe G.E., Douglas J.G., McDonald A.F. et al. Bone density in asthmatic patients taking high dose inhaled beclomethasone dipropionate and intermittent systemic corticosteroids. Thorax. 1992; 47: 414–417.
33. Wong C.A., Walsh L.J., Smith C.J. et al. Inhaled corticosteroid use and bone-mineral density in patients with asthma. Lancet. 2000; 355: 1399–1403.
34. Agertoft L., Pedersen S. Effect of long-term treatment with inhaled budesonide on adult height in children with asthma. N. Engl. J. Med. 2000; 343: 1064–1069.
35. Agertoft L., Pedersen S. Short-term lower-leg growth rate and urine cortisol excretion in children treated with ciclesonide. J. Allergy Clin. Immunol. 2005; 115: 940–945.
36. Kelly H.W., Sternberg A.L., Lescher R. et al. Effect of inhaled glucocorticoids in childhood on adult height. N. Engl. J. Med. 2012; 367: 904–912.
37. Chauhan B.F., Chartrand C., Ducharme F.M. Intermittent versus daily inhaled corticosteroids for persistent asthma in children and adults. Cochrane Database Syst. Rev. 2013; (2): CD009611.
38. Cumming R., Mitchell P., Leeder S. Use of inhaled corticosteroids and the risk of cataracts. N. Engl. J. Med. 1997; 337: 8–14.
39. Garbe E., LeLorier J., Boivin J., Suissa S. Inhaled and nasal glucocorticoids and the risks of ocular hypertension or open-angle glaucoma. J.A.M.A. 1997; 277: 722–727.
40. Mak V., Melchor R., Spiro S. Easy bruising as a side-effect of inhaled corticosteroids. Eur. Respir. J. 1992; 5: 1068–1074.
41. Autio P., Karjalainen J., Risteli L. et al. Effects of an inhaled steroid (budesonide) on skin collagen synthesis of asthma patients in vivo. Am. J. Respir. Crit. Care Med. 1996; 153: 1172–1175.
42. Dahl R. Systemic side effects of inhaled corticosteroids in patients with asthma. Respir. Med. 2006; 100 (8): 1307–1317.
Review
For citations:
Nenasheva N.M. SAFETY OF INHALED CORTICOSTEROIDS IN THE THERAPY OF BRONCHIAL ASTHMA. PULMONOLOGIYA. 2014;(3):113-120. (In Russ.) https://doi.org/10.18093/0869-0189-2014-0-3-113-120
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