Discussion topic and resource: Inhaled corticosteroids: Potency dose equivalence and therapeutic index.
Reference: British Journal of Clinical Pharmacology (Sponsored by GlaxoSmithKline), pg 372-380, 80:3.
Lead by: Dr. Tourin
Duration: 45 minutes
Discussion: This study focused on the comparison of pharmacological parameters and safety characteristics of different ICS used in treatment of asthma and COPD.
Conclusion: Current asthma treatment guidelines make assumptions about dose equivalence that position low doses as effective doses without significant risk of adverse , and high doses as those with an acceptable systemic adverse – effect profile . It is also recognized that most of the therapeutic benefit is achieved at low-mid doses and that not all patients benefit from high doses. As a higher potency can improve the therapeutic index, both efficacy and safety should be considered when classifying inhaled corticosteroid regimens in terms of dose equivalence. Current asthma guidelines rely on a simple historical approach to dose equivalence but this is not appropriate for wider range of molecules, potencies and devices/formulations now available.
-Sheena Schindle, Rep (BI); Olga Tourin, MD; Tammy Glas, RRT; Andrew Li, RRT; Stephanie Dick LPN,
Dr. Olga Tourin