Ciclesonide
Encyclopedia
Ciclesonide is a glucocorticoid
used to treat obstructive airway diseases. It is marketed under the brand name Alvesco for asthma and Omnaris/Omniair for hayfever in the US & Canada. Phase 3 trials for the hayfever indication outside the US are ongoing.
"A novel approach to minimizing the risk of toxicity from systemic absorption of an inhaled corticosteroid underlay the development of ciclesonide. This corticosteroid is inhaled as a prodrug activated by cleavage by esterases in bronchial epithelial cells. When absorbed into the circulation, the active product is tightly bound to serum proteins, and so has little access to glucocorticoid receptors in skin, eye, and bone, minimizing its risk of causing cutaneous thinning, cataracts, osteoporosis, or temporary slowing of growth"
The safety and efficacy of the nasal spray, manufactured by ALTANA Pharma US, Inc. of Florham Park, NJ, were studied in randomized placebo controlled clinical trials. The studies showed that patients treated with nasal spray had an 8-10 percent greater reduction in nasal symptoms compared to placebo, with difference between ciclesonide nasal spray and placebo significant, i.e. p<0.05.
The highest level of conversion was found in the liver, the site of inactivation of des-CIC through rapid oxidation by cytochrome P450. Carboxylesterases in bronchial epithelial cells probably contribute significantly to the conversion to des-CIC in the target organ, whereas low systemic levels of des-CIC are a result of the high metabolic clearance by the liver following CIC inhalation.
The most common side effects were headache, nosebleeds, and inflammation of the nose and throat linings.
Glucocorticoid
Glucocorticoids are a class of steroid hormones that bind to the glucocorticoid receptor , which is present in almost every vertebrate animal cell...
used to treat obstructive airway diseases. It is marketed under the brand name Alvesco for asthma and Omnaris/Omniair for hayfever in the US & Canada. Phase 3 trials for the hayfever indication outside the US are ongoing.
"A novel approach to minimizing the risk of toxicity from systemic absorption of an inhaled corticosteroid underlay the development of ciclesonide. This corticosteroid is inhaled as a prodrug activated by cleavage by esterases in bronchial epithelial cells. When absorbed into the circulation, the active product is tightly bound to serum proteins, and so has little access to glucocorticoid receptors in skin, eye, and bone, minimizing its risk of causing cutaneous thinning, cataracts, osteoporosis, or temporary slowing of growth"
Breastfeeding
Should be safe to use. Consult your medical professional.Practice Points
- Appears to be as effective as budesonideBudesonideBudesonide is a glucocorticoid steroid for the treatment of asthma and non-infectious rhinitis , and for treatment and prevention of nasal polyposis...
or fluticasoneFluticasoneFluticasone is a synthetic glucocorticoid.Both the furoate and propionate forms are used as topical anti-inflammatories:*Fluticasone propionate*Fluticasone furoateTreatment of asthma - Fluticasone in combination with Salmeterol - "[]" - aerosol....
for maintenance treatment in persistent asthma although long term data on clinical outcomes are lacking. - In short term studies ciclesonide had a minimal effect on markers of adrenal suppression but data with long term use is lacking. The US Food and Drug Administration (FDA) announced October 2006 the approval of ciclesonide nasal spray for the treatment of nasal symptoms associated with seasonal and perennial allergic rhinitis in adults and children 12 years of age and older.
The safety and efficacy of the nasal spray, manufactured by ALTANA Pharma US, Inc. of Florham Park, NJ, were studied in randomized placebo controlled clinical trials. The studies showed that patients treated with nasal spray had an 8-10 percent greater reduction in nasal symptoms compared to placebo, with difference between ciclesonide nasal spray and placebo significant, i.e. p<0.05.
The highest level of conversion was found in the liver, the site of inactivation of des-CIC through rapid oxidation by cytochrome P450. Carboxylesterases in bronchial epithelial cells probably contribute significantly to the conversion to des-CIC in the target organ, whereas low systemic levels of des-CIC are a result of the high metabolic clearance by the liver following CIC inhalation.
The most common side effects were headache, nosebleeds, and inflammation of the nose and throat linings.