Ciclesonide, a novel inhaled corticosteroid for the treatment of persistent asthma: a pharmacological and clinical profile

William R Berger

Inhaled corticosteroids (ICS) are recommended first-line therapy for asthma of all severities. Concerns regarding local and systemic side effects can influence adherence, and, therefore, efficacy and long-term asthma control. Ciclesonide is a novel ICS with an improved therapeutic margin; its efficacy is similar to that of other ICS in patients with persistent asthma. Ciclesonide is activated to desisobutyryl-ciclesonide (active metabolite) mainly in the lung, which, together with its other pharmacokinetic properties, contributes to its improved safety profile. Additionally, the drug is delivered through a hydrofluoroalkane metered-dose inhaler, which allows high lung deposition and delivery into the small airways. The improved therapeutic margin of ciclesonide may increase patient adherence, thereby ultimately improving asthma control.