© 2005 BMJ Publishing Group Ltd & British Thoracic Society
EDITORIAL
Starting dose of ICS in adult asthma
Optimal starting dose of inhaled corticosteroids in adult asthma: why has it taken so long?
1 Medical Research Institute of New Zealand, Wellington, New Zealand
2 Wellington School of Medicine & Health Sciences, Wellington, New Zealand
3 University of Southampton, Southampton, UK
Correspondence to:
Correspondence to:
Professor R Beasley
Medical Research Institute of New Zealand,P O Box 10055, Wellington, New Zealand; Richard.Beasley@mrinz.ac.nz
Start at a dose considered to be appropriate for the severity of the disease, usually 400 µg BDP or equivalent
Keywords: asthma; inhaled corticosteroids; starting dose
| The first 150 words of the full text of this article appear below. |
It is disturbing to realise that, although inhaled corticosteroids have been prescribed for over three decades in the treatment of asthma, there are still major therapeutic issues associated with their use that have yet to be clearly determined. One of these issues is the optimal starting dose. This uncertainty is illustrated by the different approaches that have been proposed for starting inhaled corticosteroids in patients with asthma ranging from "start with a high dose then step down once control has been achieved",1,2 "start with a dose of 400 µg3 or 200–500 µg per day beclomethasone dipropionate (BDP) or equivalent and then step up if required",4 or "start at the dose considered to be appropriate for the severity of disease, usually 400 µg of BDP or equivalent".5
To address this uncertainty and determine the optimal starting dose of inhaled corticosteroids in adults with asthma,
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