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Related Experiment Videos

Steroid-resistant asthma: evaluation and management

S R Nimmagadda1, J D Spahn, D Y Leung

  • 1Ira J. and Jacqueline Neimark Laboratory of Clinical Pharmacology in Pediatrics, University of Colorado Health Sciences Center, Denver, USA.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology
|November 1, 1996
PubMed
Summary

Steroid-resistant asthma patients are difficult to manage and do not respond to standard glucocorticoid treatment. Diagnosis requires failure to improve on prednisone, with alternative therapies carrying potential risks.

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Area of Science:

  • Pulmonology and Allergy
  • Pharmacology

Background:

  • Steroid-resistant asthma is a severe, challenging condition where patients do not respond to glucocorticoids.
  • Understanding its pathophysiology is crucial for effective management.

Purpose of the Study:

  • To define steroid-resistant asthma.
  • To review its pathophysiology, diagnosis, and treatment options.

Main Methods:

  • Evaluation of prospective and retrospective data.
  • Medline database search (1981-present) for asthma, glucocorticoids, and glucocorticoid resistance.
  • Review of relevant articles and current texts on severe asthma.

Main Results:

  • Steroid-resistant asthma is rare but difficult to manage, characterized by severe disease unresponsive to glucocorticoids.

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  • Diagnosis requires failure to achieve >15% improvement in FEV1 after a 7-14 day prednisone course.
  • Pathogenesis may involve diminished glucocorticoid receptor binding; alternative therapies like methotrexate are used.

    • Conclusions:

    • Steroid-resistant asthma presents significant challenges, with patients experiencing side effects from glucocorticoids with little benefit.
    • Rule out other conditions and address noncompliance before diagnosis.
    • Alternative therapies have potential adverse effects and limited study data in this population.