title: Advances in inhaled corticosteroid pharmacology.
abstract: Inhaled corticosteroids have been the backbone of asthma therapy for the past 20 plus years. Although they have, for the most part, been effective in controlling asthma symptoms and preventing exacerbations, not all patients are universally responsive to their beneficial effects. In addition, several recent studies have failed to demonstrate a disease-modifying effect of inhaled corticosteroids, with clinically indicated doses failing to prevent long term deterioration in lung function and potential airway "remodeling". Furthermore, it is apparent that possible side effects are still a concern with currently available formulations. Steroid characteristics, which might improve the therapeutic index of this class of medicine by enhancing efficacy while minimizing side effects, are explored, with special emphasis on the molecule, ciclesonide.
authors.affiliation: State University of New York at Stonybrook, Stonybrook, New York, USA. mzitt@optonline.net
authors.forename: Myron J
authors.initials: MJ
authors.lastname: Zitt
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011282:Pregnenediones / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D012123:Pulmonary Ventilation / Q000187:drug effects; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents; D011282:Pregnenediones; C120481:ciclesonide