Editing Corticosteroid (section)

==Pharmacogenetics==

===Asthma===
Patients' response to inhaled corticosteroids has some basis in genetic variations. Two genes of interest are CHRH1 ([[corticotropin-releasing hormone receptor 1]]) and TBX21 ([[transcription factor T-bet]]). Both genes display some degree of polymorphic variation in humans, which may explain how some patients respond better to inhaled corticosteroid therapy than others.<ref>{{cite journal | vauthors = Tantisira KG, Lake S, Silverman ES, Palmer LJ, Lazarus R, Silverman EK, Liggett SB, Gelfand EW, Rosenwasser LJ, Richter B, Israel E, Wechsler M, Gabriel S, Altshuler D, Lander E, Drazen J, Weiss ST | display-authors = 6 | title = Corticosteroid pharmacogenetics: association of sequence variants in CRHR1 with improved lung function in asthmatics treated with inhaled corticosteroids | journal = Human Molecular Genetics | volume = 13 | issue = 13 | pages = 1353–1359 | date = July 2004 | pmid = 15128701 | doi = 10.1093/hmg/ddh149 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Tantisira KG, Hwang ES, Raby BA, Silverman ES, Lake SL, Richter BG, Peng SL, Drazen JM, Glimcher LH, Weiss ST | display-authors = 6 | title = TBX21: a functional variant predicts improvement in asthma with the use of inhaled corticosteroids | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 101 | issue = 52 | pages = 18099–18104 | date = December 2004 | pmid = 15604153 | pmc = 539815 | doi = 10.1073/pnas.0408532102 | doi-access = free | bibcode = 2004PNAS..10118099T }}</ref> However, not all asthma patients respond to corticosteroids and large sub groups of asthma patients are corticosteroid resistant.<ref>{{cite journal | vauthors = Peters MC, Kerr S, Dunican EM, Woodruff PG, Fajt ML, Levy BD, Israel E, Phillips BR, Mauger DT, Comhair SA, Erzurum SC, Johansson MW, Jarjour NN, Coverstone AM, Castro M, Hastie AT, Bleecker ER, Wenzel SE, Fahy JV | display-authors = 6 | title = Refractory airway type 2 inflammation in a large subgroup of asthmatic patients treated with inhaled corticosteroids | journal = The Journal of Allergy and Clinical Immunology | volume = 143 | issue = 1 | pages = 104–113.e14 | date = January 2019 | pmid = 29524537 | pmc = 6128784 | doi = 10.1016/j.jaci.2017.12.1009 }}</ref>

A study funded by the Patient-Centered Outcomes Research Institute of children and teens with mild persistent asthma found that using the control inhaler as needed worked the same as daily use in improving asthma control, number of asthma flares, how well the lungs work, and quality of life. Children and teens using the inhaler as needed used about one-fourth the amount of corticosteroid medicine as children and teens using it daily.<ref>{{cite journal | vauthors = Sumino K, Bacharier LB, Taylor J, Chadwick-Mansker K, Curtis V, Nash A, Jackson-Triggs S, Moen J, Schechtman KB, Garbutt J, Castro M | display-authors = 6 | title = A Pragmatic Trial of Symptom-Based Inhaled Corticosteroid Use in African-American Children with Mild Asthma | language = English | journal = The Journal of Allergy and Clinical Immunology. In Practice | volume = 8 | issue = 1 | pages = 176–185.e2 | date = January 2020 | pmid = 31371165 | doi = 10.1016/j.jaip.2019.06.030 | s2cid = 199380330 }}</ref><ref>{{Cite web |date=2021-08-13 |title=Managing Mild Asthma in Children Age Six and Older |url=https://www.pcori.org/evidence-updates/managing-mild-asthma-children-age-six-and-older |access-date=2022-05-10 |website=Managing Mild Asthma in Children Age Six and Older {{!}} PCORI |language=en}}</ref>