Severe asthma

Alvesco® is an effective and well-tolerated treatment option for patients with asthma who require a step-up in their treatment.1 In patients with severe asthma, Alvesco® allows for an early and sustained reduction of oral steroid dose, while maintaining asthma control and lung function, and minimizing systemic steroid exposure.2–4
Alvesco® (800µg twice daily) also has comparable efficacy to oral prednisolone (40mg once daily) in regaining asthma control in patients who experience a worsening of their asthma.5

222 fig 2Versus fluticasone  FEV1 maintenance Bateman 2008

Figure 1: Alvesco® maintains lung function over 24 weeks in patients with moderate-to-severe persistent asthma previously well-controlled by high doses of inhaled corticosteroids at baseline3

Reproduced with permission from Elsevier.

225 fig 2Change in prednisone dose
Figure 2: At high doses, Alvesco® allows an early and sustained reduction of oral steroid dose, whilst maintaining asthma control and minimizing systemic exposure. Adapted from Bateman E, et al 2006.4

The addition of Alvesco® to existing treatment regimens (including long-acting β2-agonist-inhaled corticosteroid combinations) may also improve asthma control, and this effect may be related to an improvement in small airway abnormalities.6 


  1. Bateman ED. Efficacy and safety of high-dose ciclesonide for the treatment of severe asthma. Expert Rev Respir Med 2013;7:339-48.
  2. Adachi M, Ishihara K, Inoue H, et al. Efficacy and safety of inhaled ciclesonide compared with chlorofluorocarbon beclomethasone dipropionate in adults with moderate to severe persistent asthma. Respirology 2007;12:573-80.
  3. Bateman ED, Linnhof AE, Homik L, et al. Comparison of twice-daily inhaled ciclesonide and fluticasone propionate in patients with moderate-to-severe persistent asthma. Pulm Pharmacol Ther 2008;21:264-75.
  4. Bateman E, Karpel J, Casale T, et al. Ciclesonide reduces the need for oral steroid use in adult patients with severe, persistent asthma. Chest 2006;129:1176-87.
  5. van den Berge M, Arshad SH, Ind PW, et al. Similar efficacy of ciclesonide versus prednisolone to treat asthma worsening after steroid tapering. Respir Med 2009;103:1216-23.
  6. Nakaji H, Petrova G, Matsumoto H, et al. Effects of 24-week add-on treatment with ciclesonide and montelukast on small airways inflammation in asthma. Ann Allergy Asthma Immunol 2013;110:198-203.

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