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Stepping down inhaled steroids can cut side effects

May 21, 2003

A ‘stepdown’ approach to reduce doses of inhaled steroids in patients with chronic asthma can cut the risk of side effects without compromising asthma control, say researchers in this week’s BMJ.

Reduced dosages have already been achieved for people with mild asthma, but this is the first trial to look at those with chronic asthma.

The study involved 259 patients in Scotland with chronic stable asthma, who were being treated with high dose inhaled corticosteroids. After a one month run-in period, patients were allocated to receive either a 50% reduction in their dose (stepdown group) or no alteration to their dose (control group).

After one year, the team found no significant difference in the rate of asthma exacerbations or asthma events between the two groups.

Inhaled corticosteroids are widely accepted as the treatment of choice for patients with chronic asthma. However, they have been associated with a number of dose related side effects including bruising, cataracts, and glaucoma, say the authors.

This finding shows that a stepdown approach to inhaled corticosteroids can reduce the risk of steroid related side effects in this group of patients without compromising asthma control, they conclude.

British Medical Journal (BMJ)

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