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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
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Managing Corticosteroid-Related Comorbidities in Severe Asthma
Vidushi Sood1, Linda Rogers2, Sandhya Khurana3
1Division of Endocrinology, Diabetes, and Metabolism, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Chest
|May 21, 2021
Summary
Oral corticosteroids (OCS) are common in severe asthma but toxic. New biologic therapies can reduce OCS use and associated endocrine complications, improving patient health outcomes.
Area of Science:
- Pulmonology
- Endocrinology
- Pharmacology
Background:
- Oral corticosteroids (OCS) are frequently used for severe asthma, despite significant associated toxicities.
- Advances in biologic therapies offer potential to reduce OCS dependence and improve patient outcomes.
Purpose of the Study:
- To outline strategies for preventing and managing endocrine complications from OCS use in severe asthma.
- To provide guidance on OCS dose reduction following the introduction of steroid-sparing biologic therapies.
Main Methods:
- Identify OCS-dependent asthma patients and assess comorbidities (bone, glycemic, adrenal).
- Initiate OCS dose optimization before or with biologic therapy initiation.
- Taper OCS based on asthma control criteria and assess HPA axis function.
- Manage corticosteroid-related comorbidities.
Main Results:
- Monoclonal antibodies reduce OCS-treated exacerbations and OCS requirements.
- Systematic approach enables OCS dose reduction and management of endocrine sequelae.
- Improved patient health through reduced OCS toxicity.
Conclusions:
- Steroid-sparing biologic therapies are crucial for reducing OCS burden in severe asthma.
- Comprehensive management of endocrine complications is essential for patients on OCS.
- A structured approach facilitates safe OCS tapering and improved long-term health.
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