[Proceedings: Long-term therapy with steroids]

All glucocorticosteroids available at the present time exert a wide range of actions in every single cell of every organ. It is still not possible to dissociate the therapeutically desirable effects from the undesirable side effects, and whether this goal will ever be achieved is more than questionable. Thus, chronic treatment with steroids is invariably associated with side effects, but there are a number of therapeutic rules whose strict observance may prevent a patient in chronic need of steroid treatment from developing a second, iatrogenic disease. For example, there is strong evidence that spacing the administration or oral steroids, even without changing the 24 h dosage, may substantially decrease the steroid induced side effects without loss of therapeutic action. Another promising approach has been reported in the case of steroid dependent asthmatics, many of whom may be treated by inhalations of steroid esters with strong topical but low systemic effects.