Local side‐effects during 4‐year treatment with inhaled corticosteroids – a com between pressurized metered‐dose in and Turbuhaler®

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Abstract
Local side‐effects, such as hoarseness and oropharyngeal candidiasis, are often seen during treatment of patients with inhaled corticosteroids (ICS). We investigated whether changing from pressurized metered‐dose inhalers (pMDI) to Turbuhaler® influenced the type and frequency of local side‐effects. Local side‐effects were recorded for a 2‐year period in which 154 patients used ICS pMDI with a spacer device. They were followed for an equally long period of time (26.2 ± 5.7 months) while using Turbuhaler, as were 90 patients who received Turbuhaler as their first ICS preparation. After inhalation, all patients rinsed out their mouths with water. In experienced pMDI‐users, the frequency of local side‐effects decreased from 21% to 6%. The reduction was due to a lower incidence of hoarseness. Candidiasis or hoarseness was not seen in patients given Turbuhaler as their first ICS device. Our fear of an increased incidence of local side‐effects when giving ICS in Turbuhaler was unwarranted.