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Overview
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Background
Ciclesonide is a prodrug of the potent glucocorticoid receptor agonist desisobutyryl-ciclesonide. Ciclesonide undergoes the hydrolysis process by ester cleavage at the C21 position to desisobutyryl-ciclesonide, followed by reversible formation of fatty acid esters in lung cells. Although both ciclesonide and desisobutyryl-ciclesonide are able to bind to the glucocorticoid receptor, the active metabolite desisobutyryl-ciclesonide (IC50 = 210 nM) is about 100-fold more potent than the parent compound ciclesonide (IC50 = 1.75 nM). Formulations containing ciclesonide have been used in the maintenance treatment of asthma and in the treatment of allergic rhinitis.
1. Derendorf H, Nave R, Drollmann A, et al. Relevance of pharmacokinetics and pharmacodynamics of inhaled corticosteroids to asthma. European Respiratory Journal, 2006, 28(5): 1042-1050.
2. Mutch E, Nave R, McCracken N, et al. The role of esterases in the metabolism of ciclesonide to desisobutyryl-ciclesonide in human tissue. Biochemical Pharmacology, 2007, 73(10): 1657-1664.
3. Belvisi MG, Bundschuh DS, Stoeck M, et al. Preclinical profile of ciclesonide, a novel corticosteroid for the treatment of asthma. Journal of Pharmacology and Experimental Therapeutics, 2005, 314(2): 568-574.
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Overview