Inhaled steroids produce variable benefits in the treatment...( A new study sheds light on the differe...)

A new study sheds light on the differences in the way asthma patients respond to inhaled steroid therapy. This study conducted by the National Heart, Lung and Blood Institutes Asthma Clinical Research Network demonstrated that low to medium doses of inhaled steroids are usually sufficient to improve lung function in patients with persistent asthma.

Increasing to high doses of the inhaled steroids failed to achieve greater improvement in lung function but increased the potential risk for adverse effects. Surprisingly, about a third of the patients (eight of 21 evaluated) in the study showed minimal improvement in lung function at any dose of inhaled steroid. The findings, published in the March issue of the Journal of Allergy and Clinical Immunology, also introduce methods that could be used to identify those who will and will not respond to inhaled steroids.

Inhaled steroids have greatly improved the overall care and management of asthma during the past 10 years, said Stanley Szefler, M.D., lead author on the paper and Head of Pediatric Clinical Pharmacology at National Jewish Medical and Research Center. But we must realize that individual patients respond quite differently to inhaled steroids, and consider other therapies if low to medium doses are not providing a clear benefit.

Dr. Szefler recommends that doctors whose patients do not respond with low to medium doses of inhaled steroids consider supplementing them with non-steroidal medications, such as long-acting beta agonists and leukotriene modifiers, before prescribing high doses of inhaled steroids. When high doses of steroids are used for several years, they may be associated with an increased risk for adverse effects, such as osteoporosis, cataracts and glaucoma. However, higher doses of inhaled steroids may still be needed to help some patients control their asthma, said Dr. Szefler. He advises doctors to monitor any patients taking high doses to determine whether the benefits outweigh th
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Contact: William Allstetter
allstetterw@njc.org
303-398-1002
National Jewish Medical and Research Center
19-Mar-2002