Risks and benefits of periodic treatment of asthma with inhaled corticosteroids

It is important to determine whether inhaled corticosteroids can be discontinued during a stable phase of asthma. So far, most studies have shown that it is not possible to discontinue medication. We studied 14 patients with corticosteroid-dependent asthma who had shown a decline in forced expiratory volume in 1 second (FEV1) of at least 80 ml/year and at least 1 exacerbation per year during 2 years of bronchodilator treatment. Patients were then treated additionally with inhaled corticosteroids for another 2 years and were then given the option to discontinue corticosteroids. The course of FEV1 during the year in which corticosteroids were discontinued was not significantly different from that in the 2-year period of corticosteroid treatment. Furthermore, there was no change in other lung function parameters, symptom score or exacerbation rate. Discontinuing inhaled corticosteroids might be possible in some patients with asthma after 2 years of regular treatment. This may indicate that, for certain groups of patients with mild asthma, periodic treatment with inhaled corticosteroids is the treatment policy for the future.