Corticosteroids – Inhaled

CORTICOSTEROIDS – INHALED (BECLOMETHASONE – BECLOVENT^®, BECONASE^®, VANCENASE^®, VANCERIL^®) (BUDESONIDE – RHINOCORT^®)

Primary Use

For treating asthmatic, allergic and chronic lung diseases.

Clinical Concerns

A report in the Journal of the American Medical Association (Garbe, Suissa and Lelorier, 1998) states that inhaled corticosteroids taken at high doses for longer than 3 years increased patients’ risk of under-going cataract extraction threefold compared with a control group.

Comments

•  Glaucoma induced by inhaled steroid use is well documented.

•  Analysis of 416 cases in which patients used inhaled steroids but had not used systemic steroids for at least 5 years shows increased inci-dence of cataract surgery.

•  This is the first report to investigate risk according to daily dose of inhaled steroids and duration of use (> 1 mg of beclomethasone or budesonide per day).

•  Systemic steroid use causes a statistically signifi-cant increase, after just 1 year of therapy, in the incidence of cataract surgery in the elderly in this same study.

•  As study points out, while there are many variables in this research, this indirect evidence suggests that we may have markedly underestimated the poten-tial of inhaled steroids as a cataractogenic co-factor in the elderly.