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Previous Volume 332:868-875 March 30, 1995 Number 13 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Glucocorticoids are the most effective therapy available for patients with asthma. They may be administered either orally or, much more safely, by inhalation. With the recognition that airway inflammation is present even in patients with mild asthma, therapy with inhaled glucocorticoids is now recommended at a much earlier stage.¹ However, despite their proved efficacy in the treatment of asthma, enthusiasm for their use has been tempered by concern about systemic side effects. Because of this concern, less effective therapies are often preferred, particularly for children.

Mechanism of Action

Molecular Mechanisms

Inhaled glucocorticoids are highly lipophilic. They rapidly enter airway cells, where they bind to cytosolic . . . [Full Text of this Article]

Cellular Effects

Effects on Inflammation

Effects on Airway Hyperresponsiveness

Clinical Efficacy

Studies in Adults

Studies in Children

Prevention of Irreversible Changes

Reduction in Mortality

Effects on Chronic Obstructive Pulmonary Disease

Comparisons of Different Preparations

Pharmacokinetics

Frequency of Administration

Local Side Effects

Dysphonia

Oropharyngeal Candidiasis

Other Local Complications

Systemic Side Effects

Effect of the Delivery System

Suppression of Hypothalamic–Pituitary–Adrenal Function

Effects on Bone Metabolism

Effects on Growth

Effects on Connective Tissue

Cataracts

Metabolic Effects

Hematologic Effects

Central Nervous System Effects

Safety in Pregnancy

Comparison with Other Therapies

Conclusions

Source Information

From the Department of Thoracic Medicine, National Heart and Lung Institute, Dovehouse St., London SW3 6LY, United Kingdom, where reprint requests should be addressed to Professor Barnes.

References

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Inhaled Corticosteroids and the Risk of Cataracts
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Extract | Full Text  
N Engl J Med 1997; 337:1554-1555, Nov 20, 1997. Correspondence

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