Inhaled Corticosteroids in Asthma

This is nothing new, but data continue to accumulate showing inhaled corticosteroids prevent asthma exacerbations, even in very young kids.

Asthma is a disease of inflammation in the lungs, and the inflammation is there all the time, even when patients aren't having symptoms. Regular use of inhaled corticosteroids (note these steroids are distinct from the anabolic steroids apparently used by most Major League Baseball players) decreases this inflammation and prevents serious asthma attacks. I children, these attacks are often caused by viral infections.

One of the challenges of being an asthma doctor is convincing parents and patients that medicine is necessary every day, even when kids don't have symptoms. You'd be surprised how many parents don't want to believe their child has a chronic illness, even after multiple hospitalizations and even ICU stays.

Interestingly, use of anti-inflammatories like inhaled steroids don't cure the disease, they just decrease morbidity. A number of large trials have showed that once inhaled steroids are discontinued, patients quickly go back to being just like untreated patients.