Daily high-dose inhaled corticosteroids are associated with a fourfold increased risk of pneumonia and major adverse cardiac events in adults with asthma, UK researchers say.

Use of daily low-dose inhaled corticosteroids (ICS) — ≤200µg of beclomethasone equivalents — were not associated with any adverse outcomes up to a year later.

“Our findings therefore support current guideline recommendations that … ICS should be prescribed at the lowest dose to control a person’s asthma,” the team from Imperial College London wrote in the American Journal of Respiratory and Critical Care Medicine last month.

In a linked editorial, respiratory physicians said the findings suggested that high-dose ICS should be avoided, especially over the long term.