Differential effects of inhaled corticosteroids in smokers/ex-smokers and nonsmokers with asthma

Nicolas Roche, Dirkje S Postma, Gene Colice, Anne Burden, Theresa W Guilbert, Elliot Israel, Richard J Martin, Willem M C van Aalderen, Jonathan Grigg, Elizabeth V Hillyer, Julie von Ziegenweidt, David B Price

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)


Cigarette smoking decreases corticosteroid sensitivity in patients with asthma and worsens their symptoms and exacerbation frequency. Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment. However, the optimal therapies for smokers with asthma are not well defined because smokers (and ex-smokers with a >10 pack-year history) are usually excluded from clinical trials. Exposure to even low levels of cigarette smoke is known to induce small airway inflammation (5, 6), which is associated with worse asthma control. Therefore, ICS deposition in small airways, which increases with small- versus standard-size–particle ICS, might be an important determinant of ICS effectiveness in smokers with asthma.
Original languageEnglish
Pages (from-to)960-964
Number of pages5
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number8
Publication statusPublished - 15 Apr 2015

Bibliographical note

Supported by an unrestricted grant from Teva Pharmaceuticals Limited of Petach Tikva, Israel (for data acquisition and analysis). Access to data from the Optimum Patient Care Research Database was cofunded by Research in Real-Life Ltd.


  • Inhaled Corticosteroids
  • Smokers
  • Ex-Smokers
  • Non Smokers
  • Differential Effects


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