Allergy, Asthma and Immunology: Local adverse effects associated with the use of inhaled corticosteroids in patients with moderate or severe asthma

Jornal Brasileiro de Pneumologia

Print version ISSN 1806-3713

J. bras. pneumol. vol.39 no.4 São Paulo July/Aug. 2013

http://dx.doi.org/10.1590/S1806-37132013000400003

ORIGINAL ARTICLES

Charleston Ribeiro Pinto1, Natalie Rios Almeida2, Thamy Santana Marques3, Laira Lorena Lima Yamamura4, Lindemberg Assunção Costa5, Adelmir Souza-Machado6

¹Assistant Professor. Undergraduate Course in Pharmacy, Department of Chemistry and Exact Sciences, Southwestern Bahia State University, Jequié, Brazil

²Medical Student. Bahia School of Medicine and Public Health, Salvador, Brazil

³Resident in General Surgery. Roberto Santos General Hospital, Salvador, Brazil

⁴Pharmacist. Bahia State Health Department, Salvador, Brazil

⁵Assistant Professor. Federal University of Bahia School of Pharmacy, Salvador, Brazil

⁶Adjunct Professor. Institute of Health Sciences, Federal University of Bahia; and Coordinator. Programa para o Controle da Asma na Bahia – ProAR, Bahia State Asthma Control Program – Salvador, Brazil

ABSTRACT

OBJECTIVE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

Self-reported adverse effects related to ICS use were common among the asthma patients evaluated here.

Key words: Asthma; Glucocorticoids; Administration, inhalation; Pharmaceutical services