Inhaled Corticosteroids as Asthma Treatment Options

Asthma Inhaler
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Inhaled corticosteroids (ICS), also known as inhaled steroids, are the most potent anti-inflammatory controller medications available today for the treatment of asthma and are used to decrease the frequency and severity of asthma symptoms. They are the current mainstay of treatment once a person with asthma needs a higher level of care than a rescue inhaler

Common inhaled corticosteroids include:

  • Flovent (fluticasone)
  • Pulmicort (budesonide)
  • Azmacort (triamcinolone)
  • Aerobid (flunisolide)
  • Qvar (beclomethasone)

Inhaled corticosteroids improve asthma control more effectively than any other agent used as a single treatment. However, it is important to note that inhaled corticosteroids cannot relieve an asthma attack already in progress and a rescue inhaler is still needed for those situations.

Inhaled corticosteroids help prevent chronic asthma symptoms such as:

How Inhaled Corticosteroids Work

Inhaled corticosteroids prevent asthma symptoms by reducing inflammation in the bronchial tubes, or airways, that carry oxygen to the lungs. In addition, they reduce the amount of mucous produced by the bronchial tubes. This is achieved by blocking the late-phase immune reaction to an allergen, reducing airway hyperresponsiveness, and decreasing inflammation and inhibiting inflammatory cells such as mast cells, eosinophils, and basophils.

 

Since inhaled corticosteroids act locally in the airway, minuscule amounts of the medicine make its way into the rest of the body. Therefore, the risk of potentially serious side effects commonly experienced by people taking systemic steroid medications is significantly lower. Overall, the risks associated with inhaled corticosteroids are very low, but there are several things you can do to decrease your risk of side effects.

You and your physician may want to consider inhaled corticosteroids if any of the following apply:

  • You use rescue β-agonist treatments, such as Albuterol, more than two days per week.
  • You have asthma symptoms more than twice weekly.
  • You meet certain criteria on spirometry.
  • Your asthma interferes with your daily activities.
  • You have needed oral steroids 2 or more times in the last year.

How Effective Are Inhaled Corticosteroids?

Generally, inhaled corticosteroids are used for long-term treatment of asthma in people of all ages who require daily management. They are effective in preventing asthma attacks but require daily use in regularly spaced doses in order to be effective. In addition, they may not be effective for up to six weeks after you begin using inhaled corticosteroids, and several months of regular use may be required to notice the full effects. A rescue inhaler may still be necessary to treat asthma attacks when they occur. 

While not all patients respond similarly to inhaled corticosteroids, they have been found to improve a number of important asthma outcomes such as:

  • Need for oral steroids
  • Frequency of ER visits and hospitalizations
  • Deaths

Sources:

National Heart, Lung, and Blood Institute. Accessed: August 16, 2009. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma

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