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Side Effects With Inhaled Corticosteroids: Conclusion

John Courtney
Posted in November 29th, 2014
Published in Asthma
Tags: adverse events, asthma, inhaled corticosteroids, safety, side effects
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How often do you monitor for (1) systemic or (2) local adverse events? When asked to rate the overall safety of ICS on a scale of 1 (very safe) to 6 (dangerous), 25% of participants in this meeting rated ICS as very safe, most (40%) chose 2 on the scale, and 35% chose 3 or […]

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Side Effects With Inhaled Corticosteroids: Physician Perception of Side Effects With ICS Therapy

John Courtney
Posted in November 28th, 2014
Published in Asthma
Tags: adverse events, asthma, inhaled corticosteroids, safety, side effects
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A survey of 429 US family physicians and pediatricians in managed-care organizations was conducted by the Pediatric Asthma Care Patient Outcomes Research Team. This survey focused on physicians’ concerns and perceptions. Although 26% of responders thought ICS were very safe and 66% thought they were safe, 47% were at least moderately concerned regarding one or […]

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Side Effects With Inhaled Corticosteroids: Systemic Side Effects

John Courtney
Posted in November 27th, 2014
Published in Asthma
Tags: adverse events, asthma, inhaled corticosteroids, safety, side effects
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The only specific recommendation for monitoring systemic side effects made in the NAEPP 1997 guidelines was to monitor growth in children. However, based on the evidence available at the time, the guidelines recommended the following measures for minimizing potential systemic side effects with ICS: Here • Use a spacer device and rinse the mouth after […]

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Side Effects With Inhaled Corticosteroids: Control and Monitoring of Side Effects Local Side Effects

John Courtney
Posted in November 26th, 2014
Published in Asthma
Tags: adverse events, asthma, inhaled corticosteroids, safety, side effects
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The only other systemic side effect with ICS mentioned in the NAEPP 1997 guidelines was disseminated varicella infection. While oral corticosteroid use, with or without immunosuppression, has been associated with a high risk of severe varicella infection compared with case-matched control sub-jects, no causal relationship has been shown with ICS, despite sporadic case reports of […]

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Side Effects With Inhaled Corticosteroids: Systemic Side Effects in Children

John Courtney
Posted in November 25th, 2014
Published in Asthma
Tags: adverse events, asthma, inhaled corticosteroids, safety, side effects
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Oral corticosteroids are a known risk factor for the development of subcapsular cataracts, with risk influenced by daily cumulative dose, age, and ethnic origin. The systematic review described above concluded that the risk of cataracts due to ICS was small and may only be relevant in elderly patients. Two studies not included in the systematic […]

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Side Effects With Inhaled Corticosteroids: Risk of Systemic Side Effects

John Courtney
Posted in November 24th, 2014
Published in Asthma
Tags: adverse events, asthma, inhaled corticosteroids, safety, side effects
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While safety data have been reported for many clinical trials, there are few studies that have been adequately powered, or have long enough follow-up periods, to assess long-term systemic side effects with ICS. A systematic review conducted in collaboration between the American College of Chest Physicians, the American Academy of Allergy, Asthma, and Immunology, and […]

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Side Effects With Inhaled Corticosteroids: Asthma Clinical Research

John Courtney
Posted in November 23rd, 2014
Published in Asthma
Tags: adverse events, asthma, inhaled corticosteroids, safety, side effects
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Modern delivery systems, such as HFA-based pMDI inhalers, enhance drug targeting to the lungs. Thus, lower ICS doses can be used, such that the clinical response is maintained but systemic exposure reduced. For example, conversion from CFC to HFA as a propellant moved the dose-response curve for drugs delivered using the HFA device toward the […]

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