[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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Abstract
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.
期刊介绍：
The Japanese Society of Allergology is made up of medical researchers and clinical physicians who share an involvement in the study of allergies and clinical immunology. Clinical subspecialties include such allergies and immune-response disorders as bronchial asthma, hypersensitivity pneumonitis, collagen disease, allergic rhinitis, pollenosis, hives, atopic dermatitis, and immunodeficiency. However, there are many patients afflicted by other allergies as well. The Society considers all such patients and disorders within its purview.
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