Prolonged Treatment With Steroids in Severe Chronic Asthma

Oral corticosteroids stewardship for asthma in adults and adolescents: A position paper from the Thoracic Society of Australia and New Zealand

“…A number of case series published in the 1960s showed clinical benefits in asthma-symptom free days, reduced bronchodilator use and improved daily function, usually measured as ability to return to normal work duties. 74,75 OCS can effectively suppress eosinophilic inflammation, the key driver of exacerbations in most people with asthma, and relationships between OCS dose and eosinophilic inflammation and the lag between increases in sputum markers and clinical features have been demonstrated in longitudinal observational studies. 76 ICS were subsequently shown to be as effective as low-dose oral prednisolone for maintenance treatment in the majority of patients with asthma, and with fewer adverse effects.…”

Difficulties in Weaning in Steroid Treatment of Asthma

“…In spite of the M.R.C. 's unenthusiastic report on this long-term use, most subsequent workers have not agreed, and this opposing view is well summarized by Phear et al (1960).…”

“…Williams (1959) reported 202 patients, some of whom had been followed since 1951: 121 (60%) needed continuous treatment, 43 (21 %) had intermittent treatment, and 38 (19%) had only a single course of treatment. Phear et al (1960) treated 50 patients for three to six months, and only 6 (12%) remained well and off steroids. Of the 701 patients described, sufficient details are given about 538 to say that 463 (86%) of them were still taking steroids at the end of the period of observation.…”

Corticosteroids in treatment of chronic asthma.

“…J7., 1966, 2, 796-802 Chronic or continuous bronchial asthma is a disabling and potentially dangerous disorder, for which the only effective treatment in the majority of cases is the administration of corticosteroids. There was at first some reluctance to use these agents on a long-term basis, mainly because of a discouraging report from the Medical Research Council (1956), but in the past nine years many well-documented studies have testified to the value of this form of treatment (Phear, Ball, and Page, 1960;Bruce Pearson, Baylis, and Smellie, 1961;Livingstone and Davies, 1961;Rees and Williams, 1962). There are indeed few respiratory physicians who do not now believe that it is indispensable to the management of severe chronic asthma.…”