IS INHALED CORTICOSTEROID STEP-DOWN RECOMMENDED FOR ADULT ASTHMA PATIENTS HAVE BEEN WELL CONTROLLED OVER THE LONG TERM WITH MODERATE OR HIGH-DOSE INHALED CORTICOSTEROIDS?
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- Okada Naoki
- Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine
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- Kabata Hiroki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine
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- Tanaka Yoshihito
- Department of Respiratory Medicine, National Hospital Organization Hirosaki General Medical Center
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- Homma Tetsuya
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine
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- Mikura Sunao
- Shirakawa Satellite for Teaching And Research in General Medicine, Fukushima Medical University Research Associate
Bibliographic Information
- Other Title
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- CQ6 成人喘息患者の長期管理において，中用量以上の吸入ステロイド薬（ICS）により12週間以上コントロール良好な場合にICSの減量（ステップダウン）は推奨されるか
Abstract
<p>We conducted a systematic review to examine whether step-down of inhaled corticosteroid (ICS) is recommended for adult patients with asthma have been well controlled with moderate or high-dose inhaled corticosteroids for more than 12 weeks. Seven randomized controlled trials were included. ICS step-down did not increase asthma exacerbations requiring systemic steroid therapy and hospitalization. There was no effect on respiratory function, asthma control, or QOL. No significant differences were observed in serious adverse events or steroid-related adverse events, but the observation period was insufficient to assess long-term effects. Based on these results, we weakly recommend ICS step-down in adult patients with asthma have been well controlled with moderate or high-dose inhaled corticosteroids, but long-term asthma control and the incidence of steroid-related adverse events should be further investigated in the future.</p>
Journal
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- Japanese Journal of Allergology
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Japanese Journal of Allergology 73 (2), 206-212, 2024
Japanese Society of Allergology