title: [National consensus regarding the prescription of inhaled corticosteroids in cystic fibrosis].
abstract: The conditions for the prescription of inhaled steroids (ISs) in cystic fibrosis (CF) are not well established.
  
  
  OBJECTIVE
  To propose a formalized consensus agreement regarding the prescription of ISs in this disease.
  
  
  METHODS
  Application of the Delphi method in five thematic fields: indications, non-indications, dosage, precautions for use, and treatment follow-up.
  
  
  RESULTS
  Thirty of forty-nine (61 %) reference CF centers in France participated in the process, which comprised three rounds. Experts strongly agreed that ISs are indicated in the presence of pulmonary manifestations with wheezing, personal history of atopy, and/or bronchial hyper-responsiveness. In contrast, ISs are not indicated as first-line therapy for allergic bronchopulmonary aspergillosis. Strong agreement was reached regarding the daily dose of ISs, which should be similar to what is given in asthma and adapted to control symptoms so as to prescribe the smallest possible dose. Increasing the frequency of bacterial and fungal sputum analyses and eye (cataract) assessments was not deemed necessary. However, in case of prolonged (>6months) use of high-dose ISs, monitoring bone mineral density and the hypothalamic-pituitary-adrenal axis, in particular if itraconazole is concomitantly prescribed, was recommended.
  
  
  CONCLUSIONS
  This consensus statement defines a perimeter for the prescription of ISs in CF, with the aim of limiting their prescription (until new data are available).
authors.affiliation: Département de pédiatrie, CRCM pédiatrique, centre d'investigation clinique (CIC 0005), CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France. Electronic address: michael.fayon@chu-bordeaux.fr.
authors.forename: M
authors.initials: M
authors.lastname: Fayon
authors.affiliation: Service de pneumologie pédiatrique, CRCM pédiatrique, centre de référence des maladies respiratoires rares, hôpital Trousseau, AP-HP, 75012 Paris, France; Unité Inserm U938, université Pierre et Marie-Curie-Paris-6, 75012 Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Corvol
authors.affiliation: CHU de Montpellier, hôpital Arnaud de Villeneuve, CRCM mixte, 34295 Montpellier cedex 5, France.
authors.forename: R
authors.initials: R
authors.lastname: Chiron
authors.affiliation: Département de pédiatrie, CRCM pédiatrique, centre d'investigation clinique (CIC 0005), CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Bui
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000367:Age Factors; D016535:Bronchial Hyperreactivity / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000188:drug therapy*; D003697:Delphi Technique; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D008134:Long-Term Care; D008297:Male; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones