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| |  Risk of Treatment Must Be Weighed Against Benefits, Says Academy MILWAUKEE -- July 2, 1997 -- Allergists from the American Academy of Allergy, Asthma and Immunology (AAAAI) are interested in a recent article in the New England Journal of Medicine (Use of Inhaled Corticosteroids and the Risk of Cataracts. Cumming RG, et.al., 1997; 337:6-14) suggesting that patients who use inhaled corticosteroids for the treatment of asthma are at a greater risk for developing cataracts. The study from Australia is the first to show this association and the results will require confirmation. Additional studies are required that can more carefully address the question of dosage and risk as well as demonstrate that cataracts are clinically significant, the AAAAI sais in a statement. "If the conclusions are correct that inhaled steroids increase the chance of a person developing cataracts, the risk must be weighed against the proven benefits of inhaled corticosteroids in asthma," said Gary S. Rachelefsky, M.D., AAAAI President. "Regular use of inhaled corticosteroids in patients with asthma has been demonstrated to decrease their symptoms." Dr. Rachelefsky added that inhaled steroids have also been shown to prevent the more rapid loss of lung function experienced by some patients. Asthma is an inflammatory disease with significant morbidity and mortality rates. Therefore, the AAAAI believes that inhaled corticosteroids should remain the first line therapy for most adults with persistent asthma as recommended in the newly released National Heart Lung and Blood Institute (NHLBI) guidelines. The study reinforces the importance of step-down therapy of asthma; tapering inhaled steroids to the lowest dose required to control asthma, and perhaps employing the co-administration of other medications which have been shown to have steroid-sparing properties, according to the AAAAI. Since any increased risk of cataracts with inhaled corticosteroids is likely to be associated with using moderate to high doses over long periods of time, it is not appropriate for patients to make self modifications in inhaled steroids use that might have a harmful effect on asthma control. The question of appropriate modifications in inhaled corticosteroids should be discussed with a physician. Regular ophthalmologic evaluations of patients taking moderate-to-high dose inhaled corticosteroids appears prudent. The AAAAI is the largest national medical specialty organization representing allergists, clinical immunologists and allied health professionals with an interest in allergic diseases. Established in 1943, the Academy has more than 5,400 members in the United States, Canada and 41 other countries.
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