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Advisor(s)
Abstract(s)
Although the prevalence of severe asthma is not high (5–10% of patients), it is responsible for a large part of the overall disease burden and costs (50–60% of total costs), especially if the condition remains uncontrolled (which occurs in around 40% of cases). Currently, for patients without disease control or presenting frequent exacerbations despite optimal therapy, add-on treatments, traditionally long-acting anticholinergics, oral corticosteroids (OCS), or biologic agents (monoclonal antibodies) are recommended. Nonetheless, the long-term use of oral/systemic corticosteroids (CS) is significantly associated with adverse effects, acute and chronic complications that may decrease health-related quality of life and worsen prognosis, thus requiring additional monitoring and management. Conversely, target therapies (i.e., omalizumab, mepolizumab, reslizumab, benralizumab, and more recently, dupilumab) have been developed grounded on the different phenotypes and endotypes of severe asthma, and are gradually reducing the reliance on OCS (i.e., greater specificity for achieving disease control by reducing the risk of exacerbations and requirements for rescue medication and OCS, with limited adverse events).
Description
Keywords
Asthma Systemic corticosteroids ROSA II Project Portuguese ROSA Group
Citation
Marques J, Duarte-Ramos F, Ferreira MB, Lima R, Lopes C, Tonin FS, et al. Optimizing the use of systemic corticosteroids in severe asthma (ROSA II project): a national Delphi consensus study. Pulmonology. 2023;29(6):555-63.
Publisher
Elsevier