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Whats the optimal timing for administering once-daily inhaled corticosteroids?

A new meta-analysis published in the journalAnnals of Allergy, Asthma & Immunology,reportedthat administration of inhaled corticosteroids (ICS) once daily in the evening was associated with improved lung function compared with evening administration among patients with asthma.

Researchers performed a meta-analysis of 8 randomised controlled trial (n=1,234) identified through literature search on the Medline, EMBASE, and Cochrane Library databases. The trials investigated the clinical efficacy of ICSs administered once daily in the morning vs evening in patients with asthma.

The pooled result showed that ICS administered once daily in the evening resulted in mild improvement in the forced expiratory volume in 1 second (mean difference [MD], 0.05 L; 95% CI 0.01-0.09; P=.026) and produced significant increase in morning peak expiratory flow (PEF) (MD, 13.92 L/minute; 95% CI, 5.77-22.06; P=.001), as compared to once daily morning dose. The change in use of rescue medicine (P=.291) and the incidence of adverse events (P=.382) with once-daily ICS did not differ significantly between morning and evening dosing.

“The clinical benefit of ICS administered once daily in the evening can be considered when advising ICS as a first-line therapy in patients with asthma” authors suggested.


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