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Reducing oral corticosteroids in severe asthma (ROSA Project): a nationwide Portuguese consensus.
Claudia Chaves Loureiro1, Manuel Branco Ferreira2, Jorge Ferreira3
1Pulmonology Unit, Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Portugal; Centre of Pulmonology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
Pulmonology
|November 12, 2020
Summary
Portuguese experts reached consensus on optimizing oral corticosteroid (OCS) use in severe asthma. Key recommendations include risk assessment for OCS in exacerbations and prioritizing biological agents for eligible patients.
Area of Science:
- Pulmonology
- Allergology
- Clinical Practice Guidelines
Background:
- Severe asthma management requires optimized use of oral corticosteroids (OCS).
- A national consensus is needed to guide OCS therapy in Portugal.
- Understanding expert opinion is crucial for updating clinical guidelines.
Purpose of the Study:
- To establish a national consensus on the optimal use of oral corticosteroids (OCS) for severe asthma in Portugal.
- To identify expert agreement on therapeutic strategies, safety, and monitoring related to OCS.
Main Methods:
- A modified 3-round Delphi method involving 65 statements was employed.
- Online surveys and a face-to-face meeting were used to gather expert opinions.
- Consensus was defined as ≥90% agreement in round one and ≥85% in subsequent rounds.
Main Results:
- Forty-eight specialists participated, reaching consensus on most statements.
- A significant majority agreed on the need for OCS risk assessment in exacerbations and favorable perception of biological agents.
- Experts prioritized lung function preservation over symptom control when reducing OCS, and monitoring comorbidities was deemed imperative.
Conclusions:
- The findings provide a basis for updating severe asthma management guidelines in Portugal.
- Further research on therapy access, patient adherence, and cost-effectiveness is recommended.
- This consensus aims to improve OCS utilization and patient outcomes in severe asthma.
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