Systemic corticosteroids in asthma: A call to action from World Allergy Organization and Respiratory Effectiveness Group
Systemic corticosteroids in asthma: A call to action from World Allergy Organization and Respiratory Effectiveness Group
This call-to-action article was authored and endorsed as a joint initiative by the Respiratory Effectiveness Group and the World Allergy Organization. The aims of the article are to review the accumulating evidence on the burden of systemic corticosteroids (SCS) on patients with asthma and provide an overview of potential strategies for implementing SCS Stewardship.
Systemic corticosteroids (SCS) are a highly effective treatment for acute exacerbations and long-term symptom control in asthma. Long-term SCS use is highly prevalent across all asthma severities, occurring in over 20% of patients with severe or uncontrolled disease globally. It is now well known that exposure to both long-term and repeated acute courses of SCS is associated with a high risk of serious adverse effects (AEs) such as osteoporosis, and metabolic and cardiovascular complications, especially when prescribed when patients are taking other corticosteroids.
Because of the extensive data available on the costly and burdensome AEs associated with SCS use and the range of treatment options now available, there is a need for healthcare providers to carefully evaluate whether the benefits of SCS outweigh the potential harms, or to adopt SCS-sparing and Stewardship strategies and consider possible alternative therapies. Development of a structured and collaborative approach to SCS Stewardship is urgently required to protect patients from the potential harm of SCS use.
https://doi.org/10.1016/j.waojou.2022.100726
