In asthma management, what is the role of inhaled corticosteroids and what is a common misuse?

• A. ICS control airway inflammation; misuse is reliance on SABA without updating controller therapy and poor adherence to ICS.
• B. ICS provide bronchodilation; misuse is overuse of ICS with frequent stepping down.
• C. ICS cure asthma; misuse is reducing ICS dose.
• D. ICS are only used in chronic cough; misuse is using any inhaler.

Answer: (A)

Airway inflammation is the central issue in asthma, and inhaled corticosteroids address that directly. They are used daily as maintenance therapy to reduce inflammatory cell activity, airway edema, and hyperresponsiveness, which lowers the frequency and severity of symptoms and the need for rescue inhalers. They don’t provide immediate bronchodilation or cure asthma, but they are the mainstay for long-term control.

A common misuse is relying on a rescue inhaler (short-acting beta-agonist) for relief while not consistently using the inhaled corticosteroid or updating the controller regimen when control worsens. This leaves ongoing inflammation untreated, leading to poorer control and more exacerbations.