Buhl R
Mainz University Hospital, Mainz, Germany.
Allergy. 2006 May;61(5):518-26. doi: 10.1111/j.1398-9995.2006.01090.x.
The widespread use of inhaled corticosteroids (ICS) for the treatment of persistent asthma, although highly effective, may be associated with both systemic and local side effects. Systemic side effects of ICS have been extensively studied. In contrast, relatively few studies have been performed to specifically evaluate local side effects of ICS. These local side effects--including oropharyngeal candidiasis, dysphonia, pharyngitis, and cough--are generally viewed as minor complications of therapy. However, they can be clinically significant, affect patient quality of life, hinder compliance with therapy, and mask symptoms of more serious disease. Local side effects result from deposition of an active ICS in the oropharynx during administration of the drug. Numerous factors can influence the proportion of an inhaled dose that is deposited in the oropharyngeal cavity, including the ICS formulation, type of delivery system, and patient compliance with administration instructions. Therefore, the incidence of local side effects can vary widely. The goal in developing a new ICS is to include key pharmacologic characteristics that reduce oropharyngeal exposure to active drug while maintaining efficacy comparable with currently available ICS.
吸入性糖皮质激素（ICS）广泛用于治疗持续性哮喘，尽管疗效显著，但可能会产生全身和局部副作用。ICS的全身副作用已得到广泛研究。相比之下，专门评估ICS局部副作用的研究相对较少。这些局部副作用——包括口咽念珠菌病、声音嘶哑、咽炎和咳嗽——通常被视为治疗的轻微并发症。然而，它们在临床上可能具有重要意义，影响患者生活质量，妨碍治疗依从性，并掩盖更严重疾病的症状。局部副作用是由于在给药过程中活性ICS在口咽部沉积所致。许多因素可影响吸入剂量在口咽腔中的沉积比例，包括ICS制剂、给药系统类型以及患者对给药说明的依从性。因此，局部副作用的发生率差异很大。开发新型ICS的目标是具备关键药理学特性，在保持与现有ICS相当疗效的同时，减少活性药物在口咽部的暴露。
