The therapeutic response to steroids administered by inhalation was studied in 71 patients with severe chronic bronchial asthma. This investigation was based on the concept that topically administered steroid would result in a high local concentration of hormone on the bronchial mucosa and might so effect relief of asthma with less of the adverse reactions encountered with systemic steroid therapy. Thirty-five of the 71 patients obtained marked relief with remission in asthmatic symptoms; 23 were recorded as having moderate reduction in wheeze and obstructive dyspnea; and the remaining 13 noted little or no improvement. Clinical response was assessed in conjunction with ventilatory function studies over a period of approximately 12 months. Except for one instance of marked increase in appetite, there were no adverse hormonal reactions.
Bickerman HA, Itkin SE. Aerosol Steroid Therapy and Chronic Bronchial Asthma. JAMA. 1963;184(7):533-538. doi:10.1001/jama.1963.03700200055010