Local adverse effects associated with the use of inhaled corticosteroids in patients with moderate or severe asthma

• Published in: Jornal brasileiro de pneumologia Vol. 39; no. 4; pp. 409 - 417
• Main Authors: Pinto, Charleston Ribeiro, Almeida, Natalie Rios, Marques, Thamy Santana, Yamamura, Laira Lorena Lima, Costa, Lindemberg Assunção, Souza-Machado, Adelmir
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Sociedade Brasileira de Pneumologia e Tisiologia 01-06-2013
• Subjects: Administracao por inalacao; Administration, Inhalation; Anti-Asthmatic Agents - administration & dosage; Anti-Asthmatic Agents - adverse effects; Asma; Assistencia farmaceutica; Asthma - drug therapy; Beclomethasone - administration & dosage; Beclomethasone - adverse effects; Budesonide - administration & dosage; Budesonide - adverse effects; Cross-Sectional Studies; Female; Glucocorticoides; Glucocorticoids - administration & dosage; Glucocorticoids - adverse effects; Hoarseness - chemically induced; Humans; Male; Middle Aged; Original; Oropharynx - drug effects; RESPIRATORY SYSTEM; Severity of Illness Index; Thirst; Administracao por inalacao; Glucocorticoids; Assistencia farmaceutica; Administration, inhalation; Asma; Pharmaceutical services; Glucocorticoides; Asthma
• ISSN: 1806-3713; 1806-3756; 1806-3756; 1806-3713
• DOI: 10.1590/S1806-37132013000400003

To describe and characterize local adverse effects (in the oral cavity, pharynx, and larynx) associated with the use of inhaled corticosteroids (ICSs) in patients with moderate or severe asthma.
This was a cross-sectional study involving a convenience sample of 200 asthma patients followed in the Department of Pharmaceutical Care of the Bahia State Asthma and Allergic Rhinitis Control Program Referral Center, located in the city of Salvador, Brazil. The patients were ≥ 18 years of age and had been using ICSs regularly for at least 6 months. Local adverse effects (irritation, pain, dry throat, throat clearing, hoarseness, reduced vocal intensity, loss of voice, sensation of thirst, cough during ICS use, altered sense of taste, and presence of oral candidiasis) were assessed using a 30-day recall questionnaire.
Of the 200 patients studied, 159 (79.5%) were women. The mean age was 50.7 ± 14.4 years. In this sample, 55 patients (27.5%) were using high doses of ICS, with a median treatment duration of 38 months. Regarding the symptoms, 163 patients (81.5%) reported at least one adverse effect, and 131 (65.5%) had a daily perception of at least one symptom. Vocal and pharyngeal symptoms were identified in 57 (28.5%) and 154 (77.0%) of the patients, respectively. The most commonly reported adverse effects were dry throat, throat clearing, sensation of thirst, and hoarseness.
Self-reported adverse effects related to ICS use were common among the asthma patients evaluated here.