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[National consensus regarding the prescription of inhaled corticosteroids in cystic fibrosis].
[allergic bronchopulmonary aspergillosis]
The
conditions
for
the
prescription
of
inhaled
steroids
(
ISs
)
in
cystic
fibrosis
(
CF
)
are
not
well
established
.
To
propose
a
formalized
consensus
agreement
regarding
the
prescription
of
ISs
in
this
disease
.
Application
of
the
Delphi
method
in
five
thematic
fields
:
indications
,
non-indications
,
dosage
,
precautions
for
use
,
and
treatment
follow-up
.
Thirty
of
forty-
nine
(
61
%
)
reference
CF
centers
in
France
participated
in
the
process
,
which
comprised
three
rounds
.
Experts
strongly
agreed
that
ISs
are
indicated
in
the
presence
of
pulmonary
manifestations
with
wheezing
,
personal
history
of
atopy
,
and
/
or
bronchial
hyper-responsiveness
.
In
contrast
,
ISs
are
not
indicated
as
first
-line
therapy
for
allergic
bronchopulmonary
aspergillosis
.
Strong
agreement
was
reached
regarding
the
daily
dose
of
ISs
,
which
should
be
similar
to
what
is
given
in
asthma
and
adapted
to
control
symptoms
so
as
to
prescribe
the
smallest
possible
dose
.
Increasing
the
frequency
of
bacterial
and
fungal
sputum
analyses
and
eye
(
cataract
)
assessments
was
not
deemed
necessary
.
However
,
in
case
of
prolonged
(
>
6
months
)
use
of
high
-dose
ISs
,
monitoring
bone
mineral
density
and
the
hypothalamic
-
pituitary
-
adrenal
axis
,
in
particular
if
itraconazole
is
concomitantly
prescribed
,
was
recommended
.
This
consensus
statement
defines
a
perimeter
for
the
prescription
of
ISs
in
CF
,
with
the
aim
of
limiting
their
prescription
(
until
new
data
are
available
)
.
Diseases
Validation
Diseases presenting
"adapted to control symptoms so as to prescribe the smallest possible dose"
symptom
allergic bronchopulmonary aspergillosis
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