There are no differences in terms of benefits when comparisons are made between cystic fibrosis (CF) patients on inhaled corticosteroids and those who didn’t use inhaled steroids for a period of six months, as per a finding presented in an issue of the American Journal of Respiratory and Critical Care Medicine and published by the American Thoracic Society.

Ian M. Balfour-Lynn, M.D., F.R.C.P., of the Department of Pediatric Respiratory Medicine at Royal Brompton Hospital in London, and six associates concluded that it is safe for the affected patients to stop making use of corticosteroids to reduce their drug burden and associated adverse side effects besides saving money.

From News-Medical.Net:

CF, an inherited disorder, is characterized by the production of thick, sticky mucus that frequently obstructs the lungs. The problem can lead to life-threatening lung infections and difficulties with the pancreatic ducts, preventing normal digestion and causing patient malnutrition. Because of improved treatment techniques in recent years, however, patient survival has increased from 25 to 33 years.

“Oral corticosteroids slow the progression of CF lung disease, but long-term use is precluded by unacceptable side effects,” said Dr. Balfour-Lynn. “A systematic review of inhaled corticosteroid use in CF revealed 10 randomized controlled trials, with six having been published. The trials studied 293 adults and children. Although there was variable methodological quality among the studies, the conclusion was that there was ‘no evidence from existing trials to support the practice of prescribing inhaled steroids in cystic fibrosis.’”

The authors noted that 52 percent of the patients were on high-dose inhaled corticosteroids (1,000 micrograms or more per day). At those levels, the drug can lead to significant symptoms related to adrenal suppression and insufficiency. Also, among pediatric patients, slowing of linear growth has been a problem for individuals taking the drug for a year or more.

Dr. Balfour-Lynn said that replacing the corticosteroids with a placebo is a safe and effective option as it does not lead to a significant increase in lung-related adverse effects leading to withdrawal from the study, nor an increased need for oral corticosteroids.