PMID- 36582404
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230103
IS  - 1939-4551 (Print)
IS  - 1939-4551 (Electronic)
IS  - 1939-4551 (Linking)
VI  - 15
IP  - 12
DP  - 2022 Dec
TI  - Systemic corticosteroids in asthma: A call to action from World Allergy 
      Organization and Respiratory Effectiveness Group.
PG  - 100726
LID - 10.1016/j.waojou.2022.100726 [doi]
LID - 100726
AB  - Systemic corticosteroids (SCS) are a highly effective treatment for acute 
      exacerbations and long-term symptom control in asthma. Long-term SCS use is 
      highly prevalent across all asthma severities, occurring in over 20% of patients 
      with severe or uncontrolled disease globally. It is now well known that exposure 
      to both long-term and repeated acute courses of SCS is associated with a high 
      risk of serious adverse effects (AEs), such as osteoporosis, and metabolic and 
      cardiovascular complications, especially when prescribed onto a background of 
      other corticosteroids. The aim of this call-to-action article, endorsed by the 
      World Allergy Organization and the Respiratory Effectiveness Group, is to review 
      the accumulating evidence on the burden of SCS on patients with asthma and 
      provide an overview of potential strategies for implementing SCS Stewardship. 
      Primary prevention of exacerbations and improvement of asthma control is a key 
      first step in achieving SCS Stewardship, by optimizing maintenance asthma 
      medications and addressing modifiable risk factors, such as adherence and inhaler 
      technique. Other key elements of SCS Stewardship include increasing appropriate 
      specialist referrals for multidisciplinary review, assessment of biomarkers, and 
      consideration of oral corticosteroid-sparing add-on therapies (eg, biologics). In 
      cases where SCS use is deemed clinically justified, it should be tapered to the 
      lowest possible dose. In addition, patients receiving long-term SCS or frequent 
      acute courses should be closely monitored for emergence of SCS-related AEs. 
      Because of the extensive data available on the costly and burdensome AEs 
      associated with SCS use, as well as the range of treatment options now available, 
      there is a need for healthcare providers (HCPs) to carefully evaluate whether the 
      benefits of SCS outweigh the potential harms, to adopt SCS-sparing and 
      Stewardship strategies, and to consider alternative therapies where possible. 
      Development of a structured and collaborative SCS Stewardship approach is 
      urgently required to protect patients from the potential harm of SCS use.
CI  - (c) 2022 The Authors.
FAU - Bleecker, Eugene R
AU  - Bleecker ER
AD  - Division of Genetics, Genomics and Precision Medicine, Department of Medicine, 
      University of Arizona, Tucson, AZ, USA.
FAU - Al-Ahmad, Mona
AU  - Al-Ahmad M
AD  - Microbiology Department, College of Medicine, Kuwait University, Kuwait City, 
      Kuwait.
FAU - Bjermer, Leif
AU  - Bjermer L
AD  - Department of Respiratory Medicine and Allergology, University Hospital, Lund, 
      Sweden.
FAU - Caminati, Marco
AU  - Caminati M
AD  - Department of Medicine, University of Verona, Verona, Italy.
FAU - Canonica, Giorgio Walter
AU  - Canonica GW
AD  - Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.
AD  - Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research 
      Center, IRCCS, Rozzano, Italy.
FAU - Kaplan, Alan
AU  - Kaplan A
AD  - Family Physician Airways Group of Canada, Stouffville, ON, Canada.
AD  - Department of Family and Community Medicine, University of Toronto, Toronto, ON, 
      Canada.
FAU - Papadopoulos, Nikolaos G
AU  - Papadopoulos NG
AD  - Division of Infection, Immunity & Respiratory Medicine, Royal Manchester 
      Children's Hospital, University of Manchester, Manchester, UK.
AD  - Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital 'P&A 
      Kyriakou', University of Athens, Athens, Greece.
FAU - Roche, Nicolas
AU  - Roche N
AD  - Department of Respiratory Medicine, APHP. Centre Universite Paris Cite, Cochin 
      Hospital (AP-HP) and Institute (UMR1016), Paris, France.
FAU - Ryan, Dermot
AU  - Ryan D
AD  - Usher Institute, University of Edinburgh, Edinburgh, UK.
FAU - Tohda, Yuji
AU  - Tohda Y
AD  - Kindai University Hospital, Osaka, Japan.
FAU - Yanez, Anahi
AU  - Yanez A
AD  - Center for Research on Allergies and Respiratory Diseases (InAER), Buenos Aires, 
      Argentina.
FAU - Price, David
AU  - Price D
AD  - Observational and Pragmatic Research Institute, Singapore.
AD  - Centre of Academic Primary Care, Division of Applied Health Sciences, University 
      of Aberdeen, Aberdeen, UK.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20221210
PL  - United States
TA  - World Allergy Organ J
JT  - The World Allergy Organization journal
JID - 101481283
PMC - PMC9761384
OTO - NOTNLM
OT  - Adverse effects
OT  - Burden
OT  - Severe asthma
OT  - Systemic corticosteroids
EDAT- 2022/12/31 06:00
MHDA- 2022/12/31 06:01
PMCR- 2022/12/10
CRDT- 2022/12/30 02:20
PHST- 2022/08/01 00:00 [received]
PHST- 2022/11/11 00:00 [revised]
PHST- 2022/11/18 00:00 [accepted]
PHST- 2022/12/30 02:20 [entrez]
PHST- 2022/12/31 06:00 [pubmed]
PHST- 2022/12/31 06:01 [medline]
PHST- 2022/12/10 00:00 [pmc-release]
AID - S1939-4551(22)00102-8 [pii]
AID - 100726 [pii]
AID - 10.1016/j.waojou.2022.100726 [doi]
PST - epublish
SO  - World Allergy Organ J. 2022 Dec 10;15(12):100726. doi: 
      10.1016/j.waojou.2022.100726. eCollection 2022 Dec.