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Corticosteroid treatment in airways narrowing
open access
Abstract
The choice of inhaled steroid depends on their pharmacologic properties (receptor affinity and systemic bioavailability). There is no convincing evidence that regular use of combination of inhaled corticosteroid and long acting-b-agonists (LABA) provides any additional benefit in patients with mild asthma. It seems that the optimal management of mild asthma is occasional use of combined therapy when symptoms are present. Long-term combined therapy with inhaled corticosteroid and LABA is still a "golden standard" in patients with moderate and severe asthma.
Corticosteroids are also used in chronic obstructive pulmonary disease (COPD) patients. Medication with CS can reduce symptoms but does not alter the course or progression of COPD. There is no effect of corticosteroids on all cause mortality in COPD patients. No suppression of inflammation was found in COPD patients treated with inhaled and oral corticosteroids, even at high doses. There is a small beneficial effect of CS against acute exacerbations in patients with severe disease, with improved clinical outcome and reduced length of hospital admission. Combination inhalers that include a LABA and CS are more effective then either component alone.
Abstract
The choice of inhaled steroid depends on their pharmacologic properties (receptor affinity and systemic bioavailability). There is no convincing evidence that regular use of combination of inhaled corticosteroid and long acting-b-agonists (LABA) provides any additional benefit in patients with mild asthma. It seems that the optimal management of mild asthma is occasional use of combined therapy when symptoms are present. Long-term combined therapy with inhaled corticosteroid and LABA is still a "golden standard" in patients with moderate and severe asthma.
Corticosteroids are also used in chronic obstructive pulmonary disease (COPD) patients. Medication with CS can reduce symptoms but does not alter the course or progression of COPD. There is no effect of corticosteroids on all cause mortality in COPD patients. No suppression of inflammation was found in COPD patients treated with inhaled and oral corticosteroids, even at high doses. There is a small beneficial effect of CS against acute exacerbations in patients with severe disease, with improved clinical outcome and reduced length of hospital admission. Combination inhalers that include a LABA and CS are more effective then either component alone.
Keywords
inhaled corticosteroids; COPD; asthma


Title
Corticosteroid treatment in airways narrowing
Journal
Advances in Respiratory Medicine
Issue
Article type
Review paper
Pages
96-100
Published online
2008-04-28
Page views
555
Article views/downloads
4897
Bibliographic record
Pneumonol Alergol Pol 2008;76(2):96-100.
Keywords
inhaled corticosteroids
COPD
asthma
Authors
Ryszarda Chazan