Systemic availability of inhaled budesonide and fluticasone propionate - Healthy versus asthmatic lungs

Inhaled corticosteroids are now recommended for the majority of patients wi th asthma. Although their therapeutic ratio is superior to that of oral cor tico steroids, their long term use is associated with several potentially i mportant adverse effects. A number of studies have compared the efficacy an d/or systemic activity of the currently available inhaled corticosteroids, but the results of many of these studies have been conflicting. Although th ere are a number of factors that may explain these conflicting results, the re is evidence that the type of individuals being studied is important. Ext rapolation of the findings from healthy individuals to patients with asthma appears to be misleading because the systemic effects of some, but not all , inhaled corticosteroids are greater in healthy individuals than in patien ts with asthma.