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Editorials |

Dosing Inhaled Steroids in Asthma : Is Once-a-Day Administration Effective?

Philip Marcus
Author and Funding Information

Affiliations: Old Westbury, NY
 ,  Dr. Marcus is affiliated with the New York College of Osteopathic Medicine.

Correspondence to: Philip Marcus, MD, MPH, FCCP, 233 East Shore Rd, Great Neck, NY 11023; e-mail: PMarcus@nyit.edu



Chest. 2003;124(4):1196-1198. doi:10.1378/chest.124.4.1196
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Inhaled corticosteroids have been available in the United States for the treatment of asthma since 1976. At the present time, five different inhaled corticosteroids have been marketed, and two new compounds are expected to be approved for use in the near future. When initially introduced, inhaled corticosteroids were prescribed routinely for use four times a day. In addition, they were generally used following the use an inhaled β-agonist bronchodilator, in an effort to bronchodilate first to ensure better steroid deposition. Also, they were used in an effort to reduce oral steroid dosage with a goal of elimination of the oral agent with its associated toxicity. In the last quarter century, we have learned a great deal about the use of inhaled corticosteroids in the management of asthma, and all guidelines14 now place inhaled corticosteroids as the primary therapy for persistent asthma. This is because of their clear efficacy, something that has been shown in numerous studies, compared with other classes of controller agents. The appreciation of the crucial role of inflammation in the pathogenesis of asthma has led to the widespread use of this class of anti-inflammatory agents.5 The use of inhaled corticosteroids has been shown to reduce airway inflammation, to decrease airway hyperreactivity, to improve airflow obstruction, and to decrease symptoms and exacerbations. The use of inhaled corticosteroids also has been shown to reduce the number of hospital readmissions6 and asthma mortality.7

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