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Editorials |

Designer Inhaled Corticosteroids : Are They Any Safer?

Brian J. Lipworth, MD
Author and Funding Information

Affiliations: University of Dundee, Dundee, Scotland
 ,  Dr. Lipworth is Professor of Allergy and Pulmonology, Asthma and Allergy Research Group, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, University of Dundee.

Correspondence to: Brian J Lipworth, MD, Professor of Allergy and Pulmonology, Asthma and Allergy Research Group, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, University of Dundee, DD1 9SY, Scotland, UK; e-mail: b.j.lipworth@dundee.ac.uk



Chest. 2005;128(3):1081-1084. doi:10.1378/chest.128.3.1081
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Extract

Inhaled corticosteroids are recommended as first-line antiinflammatory therapy for the treatment of persistent asthma in children and adults.1 The majority of patients do not experience systemic or local adverse effects at low to medium doses of commonly used inhaled corticosteroids. Attempts have been made by the pharmaceutical industry to refine topically active higher-potency second-generation inhaled corticosteroids, such as fluticasone propionate (FP) and mometasone furoate (MF), with claims of lower systemic bioactivity and hence a superior therapeutic ratio, as compared to the older first-generation drugs such as beclomethasone dipropionate and budesonide. However, clinical studies with FP and latterly MF have shown evidence of predictable dose-related systemic bioactivity such as hypothalamic-pituitary-adrenal (HPA) axis suppression.25


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