Ciclesonide (
Alvesco) is an inhaled
corticosteroid used in the preventative treatment of persistent
bronchial asthma in adults, adolescents and, in some countries, children. The
drug is delivered by a non-chlorofluorocarbon
hydrofluoroalkane (HFA)
metered-dose inhaler (MDI). In the lungs,
ciclesonide is converted to an active metabolite, which is responsible for the beneficial effects of the
drug in patients with
asthma.
Ciclesonide and its active metabolite have low systemic bioavailability and therefore have a low potential to produce systemic adverse events. Inhaled
ciclesonide delivered by HFA-MDI is effective in the prophylactic treatment of persistent
asthma in adults, adolescents and children, and is generally well tolerated. In general,
ciclesonide improves lung function and reduces
asthma symptoms and rescue medication use in adults and adolescents with
asthma of varying severity. The
drug is generally no less effective than other inhaled
corticosteroids with regard to maintaining or improving lung function and may have a more favourable tolerability profile than some other agents in this class.
Ciclesonide has also shown efficacy in paediatric patients with
asthma. Data on its long-term effects on other clinical outcomes, such as
asthma exacerbations, would be of interest. Further comparative and long-term studies would also be beneficial in order to definitively position
ciclesonide with respect to other inhaled
corticosteroids. In the meantime,
ciclesonide offers an effective and well tolerated first-line preventative treatment option for persistent
asthma.