From the Authors:
We read with interest the comments of Louis-Philippe Boulet and Parameswaran Nair regarding our review on inhaled corticosteroids (ICS) in adult asthma (1). We appreciate their agreement with our view that titration of maintenance ICS doses in accordance with changes in biomarkers of responsiveness may represent the optimal approach to ICS dosing in individual patients, particularly with biomarkers of type 2 inflammation. We also concur regarding priorities for research. As we recommend in our conclusion, a research priority is to determine the dose–response relationship of ICS in phenotypes defined by clinical characteristics such as type 2 biomarker status, and to better define how to titrate the ICS dose in accordance with changes in type 2 biomarkers in asthma. Two important goals would be to determine which patients require relatively higher doses and to establish whether any benefit of higher-dose ICS is a result of the systemically available fraction.
Footnotes
Originally Published in Press as DOI: 10.1164/rccm.201907-1408LE on July 24, 2019
Author disclosures are available with the text of this letter at www.atsjournals.org.
Reference
- 1.Beasley R, Harper J, Bird G, Maijers I, Weatherall M, Pavord ID. Inhaled corticosteroid therapy in adult asthma: time for a new therapeutic dose terminology. Am J Respir Crit Care Med. 2019;199:1471–1477. doi: 10.1164/rccm.201810-1868CI. [DOI] [PubMed] [Google Scholar]