3 Things To Know About Frequent Oral Corticosteroid Use

The Next Breath Editorial Team

March 2021

Understanding Severe Asthma

Tips & Resources

Learn more about oral corticosteroids, including their use as an asthma medicine and when to talk with a doctor about ways to achieve better asthma control.

Oral corticosteroids (OCS) are a type of medication that help to reduce inflammation and swelling in the airways and are prescribed for the treatment of asthma attacks.1,2 They come in a pill or liquid form and are often prescribed for short periods of time (in bursts), differing from inhaled corticosteroids (ICS) which are taken via an inhaler for the long-term control and management of asthma.2,3

A 2018 survey of people living with asthma in the United States found that nearly 85% had used a course of OCS in the past 12 months, and 64% had used them twice or more in the same period.2 OCS play an important role in the management of asthma flares, but there have been increasing calls from the patient advocacy and medical community to curb repeated OCS use due to concerns about unintended health risks, such as mood changes, risk of infections and weakened bones.4

Here are three things you need to know about OCS use, overexposure and what it could mean for you:

1. Frequent OCS use is a sign of uncontrolled asthma

Requiring two or more courses of OCS treatment to control symptoms within a 12 month period is a sign that your asthma is uncontrolled.5 There may be several reasons why your asthma could be uncontrolled and you should work together with your doctor to better understand why and how you can achieve a better level of asthma control.

Check out the PULSAR checklist to help spot the signs that you should consider having a conversation with your doctor.

2. OCS may not be ideal for the long-term control of asthma

OCS can help relieve symptoms, and during an asthma flare this is often the most important thing. However, the frequency of OCS use should be carefully monitored by your doctor, as repeated use is associated with several short-term side effects, such as mood changes, increased blood pressure and weight gain, and long-term side effects, such as cataracts, weakened bones and an increased risk of infections.1,4,5 The GINA Guidelines recommend avoiding the long-term use of OCS (often defined as more than three months of continuous OCS use) if other options are available.5,6

In one study, 91% of asthma patients reported being worried about the long-term effects of OCS7 so make sure to have a conversation with your doctor if you are concerned. Here’s a helpful guide for getting the most out of your appointments.

3. Frequent OCS use could indicate that you need to work with your doctor to create or update your asthma management plan

OCS remain an important treatment option in asthma management plans, which can help you know which steps to take when symptoms strike.7 However, relying on OCS as a long-term way to control symptoms may be a sign that your treatment plan should be reviewed.8 Managing your asthma is a continuous process and your management plan, developed together with your doctor, should be reviewed and updated regularly based on your asthma needs over time. This includes assessing how often you use OCS and how your plan can support in minimizing their use.

You can find more information about oral corticosteroids on OCS Overexposed, which aims to raise awareness of appropriate OCS use.

References:

  1. 1. Ping Chung LI, et al. Rational oral corticosteroid use in adult severe asthma: A narrative review. Respirology. 2020. 25(2): 161-172.
  2. 2. AAFFA. Oral Corticosteroids for Asthma. Available at: https://www.aafa.org/asthma-treatment-oral-corticosteroids-prednisone/. Accessed: February 2021.
  3. 3. AAAAI. Corticosteroids Definition. Available at: https://www.aaaai.org/conditions-and-treatments/conditions-dictionary/inhaled-corticosteroids. Accessed: February 2021.
  4. 4. AAFA. Oral Corticosteroid Stewardship Statement. November 2018. Available at: https://www.aafa.org/media/2244/oral-corticosteroid-stewardship-statement-november-2018.pdf. Accessed February 2021.
  5. 5. GINA 2020 Global Initiative for Asthma (GINA). Global Strategy for Asthma Management and Prevention. 2020. Available at: https://ginasthma.org/gina-reports/. Accessed February 2021.
  6. 6. Bleecker, Eugene R., et al. "Systematic literature review of systemic corticosteroid use for asthma management." American journal of respiratory and critical care medicine. 201.3 (2020): 276-293.
  7. 7. Cooper V, et al. Patient-reported side effects, concerns and adherence to corticosteroid treatment for asthma, and comparison with physician estimates of side-effect prevalence: a UK-wide, cross-sectional study. NPJ Prim Respir Med. 2015; 25:15026.
  8. 8. Mayo Clinic. Asthma in adults: Creating an asthma action plan. Available at: https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma/art-20044888. Accessed: February 2021.

MAT-GLB-2100350 V1.0 | February 2021

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to strive for better asthma control.

Start using your next breath today to inspire others to get informed and
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