Is Fluticasone Propionate Superior to the Other Available Inhaled Steroids?

Abstract

It is now clearly established that inflammation plays a prominent role in the pathogenesis of asthma (1,2). Thus, it is not surprising that there has been increasing emphasis on maintenance anti-inflammatory in all but the mildest asthmatics. Among the various types of maintenance therapy, inhaled glucocorticoid (GC) therapy has become widely utilized. Multiple studies have demonstrated inhaled GC to be effective and safe in both adults and children (3,4). Mainly because of concerns regarding potential systemic toxicity, inhaled glucocorticoid therapy has until recently been reserved for use in patients with moderate to severe asthma. A number of recent studies have suggested that the response to inhaled GC therapy is in part related to the duration of asthma symptoms, i.e., the longer the duration of symptoms, the poorer the response to inhaled GC therapy. The implication from these studies being that inhaled GC therapy should be started early in the course of the disease (5,6). Following this lead, the newly released guidelines from the NIH have now recommended low-dose inhaled glucocorticoid therapy for individuals with mild persistent asthma (7).