Review: inhaled corticosteroids increase risk of oral candidiasis, dysphonia, and pharyngitis in persistent asthma
Q Do inhaled corticosteroids increase risk of oral candidiasis, dysphonia, and pharyngitis in patients with persistent asthma?
Medline (January 1966 to June 2004) and EMBASE/Excerpta Medica (January 1974 to June 2004).
Study selection and assessment:
randomised, placebo controlled trials (RCTs) that evaluated oral inhaled corticosteroids (low dose <400 μg/d, medium dose 401–499 μg/d, or high dose ⩾1000 μg/d) alone or in combination in adults and adolescents with persistent asthma and reported incidence of oral candidiasis, dysphonia, or pharyngitis. Studies of patients who had chronic obstructive pulmonary disease were excluded. 23 RCTs met the selection criteria. The inhaled corticosteroids evaluated were fluticasone propionate (19 arms; 13 dry powder inhaler [DPI], 6 metered dose inhaler [MDI]), triamcinolone acetonide (8 arms; all MDI), budesonide (10 arms; 8 DPI, 2 MDI), beclomethasone dipropionate (11 arms; all MDI), and mometasone furoate (11 arms; 8 DPI, 3 MDI). Quality assessment of individual trials was based on randomisation; double blinding; clear definition of study objectives, treatments, …