Title:Ciclesonide - A Novel Corticosteroid for the Management of Asthma
VOLUME: 7 ISSUE: 2
Author(s):Deepti Chopra, Bharti Bhandari and Neeta Wardhan
Affiliation:Department of Physiology, HIMSR, Jamia Hamdard, New Delhi – 110062, India
Keywords:Asthma, ciclesonide, fluticasone, hypothalamo-pituitary-adrenal suppression, inhaled corticosteroid, oral
candidiasis, oral corticosteroid
Abstract:Ciclesonide (CIC) is a novel inhaled corticosteroid (ICS) approved by US Food and Drug Administration for
the treatment of persistent asthma, available as a pressurized metered-dose inhaler in two strengths, 80 mcg/activation and
160 mcg/activation. Ciclesonide is a corticosteroid with unique pharmacological profile including a high degree of serum
protein binding, a low oral bioavailability and rapid systemic elimination. Ciclesonide is a prodrug metabolized by
esterases to desisobutyryl ciclesonide (des-CIC), an active metabolite with a 100-fold greater affinity for the glucocorticoid
receptor. It has shown to improve pulmonary functions, reduce the need for oral corticosteroids (OCSs) and cause lesser
suppression of the hypothalamic-pituitary-adrenal axis in asthmatic patients. Clinical efficacy studies suggest that
Ciclesonide is superior to placebo and is at least as effective as several active comparators with an improved therapeutic
margin thereby improving the therapeutic outcome in patients of asthma.
