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Ciclesonide Action Pathway

Ciclesonide is a pro-drug so it is enzymatically hydrolyzed to C21-desisobutyryl-ciclesonide (des-ciclesonide or RM1), the active metabolite. … Des-ciclesonide has anti-inflammatory activity with an affinity for the glucocorticoid receptor that is 120 times higher than ciclesonide.