A Charter to Fundamentally Change the Role of Oral Corticosteroids in the Management of Asthma.


Journal

Advances in therapy
ISSN: 1865-8652
Titre abrégé: Adv Ther
Pays: United States
ID NLM: 8611864

Informations de publication

Date de publication:
06 2023
Historique:
received: 08 11 2022
accepted: 21 02 2023
medline: 29 5 2023
pubmed: 8 4 2023
entrez: 7 4 2023
Statut: ppublish

Résumé

Asthma affects 339 million people worldwide, with an estimated 5-10% experiencing severe asthma. In emergency settings, oral corticosteroids (OCS) can be lifesaving, but acute and long-term treatment can produce clinically important adverse outcomes and increase the risk of mortality. Therefore, global guidelines recommend limiting the use of OCS. Despite the risks, research indicates that 40-60% of people with severe asthma are receiving or have received long-term OCS treatment. Although often perceived as a low-cost option, long-term OCS use can result in significant health impairments and costs owing to adverse outcomes and increased utilization of healthcare resources. Alternative treatment methods, such as biologics, may produce cost-saving benefits with a better safety profile. A comprehensive and concerted effort is necessary to tackle the continued reliance on OCS. Accordingly, a threshold for OCS use should be established to help identify patients at risk of OCS-related adverse outcomes. Receiving a total dose of more than 500 mg per year should trigger a review and specialist referral. Changes to national and local policies, following examples from other chronic diseases, will be crucial to achieving this goal. Globally, multiple barriers to change still exist, but specific steps have been identified to help clinicians reduce reliance on OCS. Implementing these changes will result in positive health outcomes for patients and social and economic benefits for societies.

Identifiants

pubmed: 37027115
doi: 10.1007/s12325-023-02479-0
pii: 10.1007/s12325-023-02479-0
pmc: PMC10080509
doi:

Substances chimiques

Adrenal Cortex Hormones 0
Biological Products 0
Anti-Asthmatic Agents 0

Types de publication

Journal Article Review Research Support, Non-U.S. Gov't

Langues

eng

Pagination

2577-2594

Informations de copyright

© 2023. The Author(s).

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Auteurs

John Haughney (J)

Glasgow Clinical Research Facility, Queen Elizabeth University Hospital, Glasgow, UK. j.haughney@abdn.ac.uk.

Tonya Winders (T)

Allergy and Asthma Network, Vienna, VA, USA.
Global Allergy and Airways Patient Platform, Vienna, Austria.

Steve Holmes (S)

Park Medical Practice, Shepton Mallet, UK.

Pascal Chanez (P)

Department of Respiratory CIC Nord INSERM INRAE C2VN, Aix Marseille University, Marseille, France.

Andrew Menzies-Gow (A)

Royal Brompton and Harefield Hospitals, London, UK.

Janwillem Kocks (J)

General Practitioners Research Institute, Groningen, The Netherlands.
Observational and Pragmatic Research Institute, Singapore, Singapore.
Groningen Research Institute Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Adel H Mansur (AH)

Respiratory Medicine, Birmingham Heartlands Hospital and University of Birmingham, Birmingham, UK.

Christopher McPherson (C)

AstraZeneca, Cambridge, UK.

Giorgio Walter Canonica (GW)

Department of Biomedical Sciences, Humanitas University, Milan, Italy.
IRCCS Humanitas Research Hospital, Personalized Medicine, Asthma and Allergy, Milan, Italy.

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