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Overview of corticosteroid therapy.

The Journal of Allergy and Clinical Immunology

|August 1, 1985

Summary

Corticosteroids are effective for asthma management, particularly in severe attacks and status asthmaticus. High-dose methylprednisolone is more effective, but long-term use requires careful consideration of risks and alternative administration methods.

Area of Science:

Pulmonology
Pharmacology

Background:

Corticosteroids have been used for asthma management for over three decades.
Debate persists regarding optimal indications, dosage, and administration routes for corticosteroids in asthma care.

Purpose of the Study:

To review the established and emerging roles of corticosteroids in managing various respiratory conditions.
To provide evidence-based guidance on corticosteroid use in acute and chronic asthma, and related syndromes.

Main Methods:

Review of existing literature and clinical evidence on corticosteroid efficacy and safety in asthma.
Analysis of data concerning high-dose methylprednisolone in status asthmaticus.
Evaluation of diagnostic and therapeutic applications in bronchitis-emphysema syndrome.

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Main Results:

Objective evidence supports corticosteroid use in acute severe asthma and status asthmaticus.
High-dose methylprednisolone (125 mg q6h) demonstrated superior efficacy compared to lower doses in status asthmaticus.
Corticosteroids aid in diagnosing airway obstruction reversibility in bronchitis-emphysema.
Prophylaxis against adrenal insufficiency is crucial for patients on long-term therapy undergoing stress.

Conclusions:

Corticosteroids are valuable in severe asthma, especially when bronchodilators and cromolyn are insufficient.
For chronic severe asthma, aerosolized or alternate-day corticosteroid therapy is preferred over daily dosing to minimize side effects.
Judicious use and careful monitoring are essential to mitigate potential complications associated with corticosteroid therapy.