Corticosteroids have proven to be valuable in the treatment of asthma, but their use is limited because of the undesirable and often serious side effects from their prolonged administration. Al-temate-day administration has reduced, but not eliminated, these difficulties. As another means of reducing systemic side effects, administration of aerosol hydrocortisone, prednisolone, and dexa-methasone has been evaluated. These steroids were effective only at doses which suppressed adrenal function. Fluorinated steroid esters that are highly active topically show promise of controlling asthma at doses that do not produce systemic effects.
Triamcinolone acetonide, a nonpolar water-insoluble fluorinated corticosteroid, had been prepared in a metered-dose aerosol device propelled by dichlorodifluoromethane (Freon 12 J.” In a one-month double-blind controlled study involving 25 steroid-dependent severely asthmatic patients, triamcinolone acetonide aerosol proved superior to a placebo in reducing the oral requirement for corticosteroids. Herein we present the results of treatment of these severely asthmatic patients with triamcinolone acetonide aerosol for 12 months, emphasizing the long-term efficacy, side effects, and adrenal recovery. Hopefully, our experience will guide physicians in the management of asthmatic patients who will soon be making the transition from oral steroid therapy to aerosol steroid therapy.
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