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Asthma - Management
Which inhaled corticosteroid?
- The various inhaled corticosteroids (ICS) do not seem to differ in efficacy (assuming a potency ratio of beclometasone and fluticasone of 2:1).
- Adverse effects are class effects and do not differ significantly between the different inhaled corticosteroids at either low or high doses. Increased doses of ICS are associated with an increased risk of local and systemic adverse effects.
- CKS recommends beclometasone, budesonide, or fluticasone because they are available in a range of formulations at different doses and for a range of ages.
- Ciclesonide (available as a pressurized metered-dose inhaler) and mometasone (available as a dry-powder inhaler) are once-daily alternatives. Neither drug is licensed for children younger than 12 years. Mometasone has black triangle status and further post-marketing data are needed to confirm its safety.
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