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Titolo:
CORTICOSTEROIDS IN THE TREATMENT OF ASTHMA - PRACTICAL RECOMMENDATIONS
Autore:
MCGILL KA; JOSEPH B; BUSSE WW;
Indirizzi:
UNIV WISCONSIN HOSP & CLIN,DEPT ALLERGY & IMMUNOL,600 HIGHLAND AVE MADISON WI 53792 UNIV WISCONSIN,SCH MED,DEPT MED,DIV CLIN IMMUNOL & ALLERGY MADISON WI00000
Titolo Testata:
CLINICAL IMMUNOTHERAPEUTICS
fascicolo: 1, volume: 4, anno: 1995,
pagine: 16 - 48
SICI:
1172-7039(1995)4:1<16:CITTOA>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
BECLOMETHASONE DIPROPIONATE AEROSOL; PITUITARY-ADRENAL AXIS; STEROID-DEPENDENT ASTHMA; METERED-DOSE INHALERS; TRIAMCINOLONE ACETONIDE AEROSOL; POSTERIOR SUBCAPSULAR CATARACTS; BRONCHOALVEOLAR LAVAGE FLUID; ALTERNATE-DAY PREDNISONE; LONG-TERM TREATMENT; DOUBLE-BLIND TRIAL;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
194
Recensione:
Indirizzi per estratti:
Citazione:
K.A. Mcgill et al., "CORTICOSTEROIDS IN THE TREATMENT OF ASTHMA - PRACTICAL RECOMMENDATIONS", CLINICAL IMMUNOTHERAPEUTICS, 4(1), 1995, pp. 16-48

Abstract

Asthma treatment is currently undergoing transition as recognition ofthe important role of anti-inflammatory therapy continues. Asthma is now recognised as a chronic inflammatory process that can be modulatedby anti-inflammatory agents. The effectiveness of systemic therapy with corticosteroids has been known for decades, and aerosolised forms of corticosteroids are playing an increasingly important role in treating and preventing asthma. The early introduction of inhaled corticosteroids, along with avoidance of causal factors, may prevent or reduce progression and chronicity of this disease. The most recent guidelines,including the International Consensus, emphasise the early use of anti-inflammatory agents, including inhaled corticosteroids as first linetherapy. Currently, inhaled corticosteroids are indicated for adults and children with moderate to severe asthma. Because of the variability of asthma, treatment with inhaled corticosteroids must always be titrated individually to the lowest dosage that is adequate to maintain optimal asthma control. It must also be recognised that long term use of high dosage therapy, i.e. 2 or 3 times the conventional dosage, may offer optimal efficacy for patients with more severe asthma. Numerous studies have established the safety of inhaled corticosteroids. The risk of local and systemic adverse effects is relatively small. Furthermore, the second generation inhaled corticosteroids, such as budesonideand fluticasone, have high topical to systemic potency ratios, offering greater anti-inflammatory actions while decreasing systemic adverseeffects. We recommend that inhaled corticosteroids be considered in all patients with asthma, except for those with mild or only occasionalsymptoms. The importance of proper follow-up and comprehensive patient education should not be overlooked, since treatment failures can often be attributed to poor patient compliance or incorrect use of inhalers. Studies in the future will continue to address the important question of whether treating the inflammatory component of asthma will improve long term prognosis, and if delaying treatment promotes disease progression. Currently, clinical trials have firmly established that therapy with inhaled corticosteroids is effective, reducing the severity of the inflammatory process, and free from significant adverse effects.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/09/20 alle ore 20:16:22