Inhaled corticosteroids safety and adverse effects in patients with asthma

Publication date: Available online 3 February 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Enrico Heffler, Lorena Nascimento Girardi Madeira, Matteo Ferrando, Francesca Puggioni, Francesca Racca, Luca Malvezzi, Gianni Passalacqua, Giorgio Walter Canonica
Asthma is a common inflammatory airway disease for which the most commonly used controller medications are inhaled corticosteroids (ICS). Asthma control is difficult to achieve in individuals with severe asthma, which comprise 5-10% of individuals with asthma, even with high doses of ICS and other anti-inflammatory drugs.In this clinical context, the adverse effects of ICS (including hypothalamic-pituitary-adrenal axis suppression, reduction in growth velocity, osteoporosis, diabetes, and respiratory infections) become more probable and impacting on the quality of life of severe asthmatics. We here summarize the evidence of ICS-related adverse effects, particularly in patients with asthma. The possibility to use biologic agents earlier for severe asthma has the potential to prevent or reduce the occurrence of corticosteroid-related adverse effects, and also reduce corticosteroid-related costs.