scholarly journals High-dose and low-dose systemic corticosteroids are equally efficient in acute severe asthma

1995 ◽  
Vol 8 (1) ◽  
pp. 22-27 ◽  
Author(s):  
C.-H. Marquette ◽  
B. Stach ◽  
E. Cardot ◽  
J.F. Bervar ◽  
F. Saulnier ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Low Dose ◽  
High Dose ◽  
Acute Severe Asthma ◽  
Systemic Corticosteroids

Bone Complications of Corticosteroids

1996 ◽  
Vol 1 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Robert S. Lester
Keyword(s):  
Corticosteroid Therapy ◽  
Low Dose ◽  
Treatment Options ◽  
Osteoporotic Fractures ◽  
High Dose ◽  
Systemic Complications ◽  
High Dose Corticosteroid ◽  
Systemic Corticosteroids ◽  
Dose Corticosteroid ◽  
Bone Complications

Background: Systemic corticosteroids, a mainstay of treatment for severe dermatosis, are associated with systemic complications. Adverse effects of corticosteroids to bone represent a significant adverse effect that, is poorly understood and poorly managed. Objectives: The purpose of this article is to educate dermatologists to the current understanding of the pathogenesis, diagnosis, and treatment options available for bone complications of corticosteroids. Results: Virtually all patients chronically exposed to high-dose corticosteroid therapy lose bone mass and are at risk for osteoporotic fractures. In addition, osteonecrosis is an unpredictable complication of corticosteroid therapy that may occur with even low-dose corticosteroids. Conclusion: Optimal risk management of corticosteroid therapy includes understanding the risk factors associated with bone complications and improving communication with patients.

scholarly journals High dose and low dose systemic corticosteroids are equally efficient in acute asthma

1995 ◽  
Vol 8 (8) ◽  
pp. 1435-1435
Author(s):  
E. Carter ◽  
C.H. Marquette ◽  
B. Stach ◽  
E. Cardot
Keyword(s):  
Low Dose ◽  
Acute Asthma ◽  
High Dose ◽  
Systemic Corticosteroids

High-Dose Magnesium Infusions for Acute Severe Asthma in Children

2016 ◽  
Vol 17 (2) ◽  
pp. 177-178 ◽  
Author(s):  
Alyson K. Baker ◽  
Christopher L. Carroll
Keyword(s):  
Severe Asthma ◽  
High Dose ◽  
Acute Severe Asthma ◽  
Asthma In Children

scholarly journals Real-life effectiveness of omalizumab in difficult-to-treat versus severe asthma: a national cohort study in Belgium

2019 ◽  
Vol 5 (4) ◽  
pp. 00253-2018 ◽  
Author(s):  
Katia M.C. Verhamme ◽  
Catherine Lucet ◽  
Alain Van Meerhaeghe ◽  
Guy G.O. Brusselle ◽  
Marie-Laurence Lambert
Keyword(s):  
Severe Asthma ◽  
Absolute Risk ◽  
Real Life ◽  
Absolute Risk Reduction ◽  
High Dose ◽  
Eligibility Criteria ◽  
Systemic Corticosteroids ◽  
Asthma Patients ◽  
The Cost ◽  
Chronic Use

BackgroundGuidelines recommend omalizumab in patients with uncontrolled severe allergic asthma. We investigated real-life use of omalizumab, the proportion of patients fulfilling eligibility criteria, its costs and its effectiveness.MethodIn a cohort of asthma patients initiating treatment with omalizumab in Belgium between 2010 and 2016, we investigated fulfilment of eligibility criteria (chronic use of high-dose inhaled corticosteroids (ICSs) plus long-acting β2-agonists (LABAs) and ≥2 severe asthma exacerbations in previous year), and compared hospitalisations and systemic corticosteroid consumption in the year before and after omalizumab initiation. We computed healthcare costs in the respective time periods and compared the cost per prevented hospitalisation in patients fulfilling eligibility criteria versus those who did not.ResultsBetween 2010 and 2016, omalizumab treatment was initiated in 2068 patients with asthma; only 24% fulfilled the eligibility criteria, mainly due to nonadherence to high-dose ICSs + LABAs. The proportion of patients hospitalised for asthma decreased from 41% to 21% in eligible patients (absolute risk reduction, 20%), whereas the absolute risk reduction was 5% (from 19% to 14%) in noneligible patients. The cost per prevented hospitalisation was €44 238 versus €139 495, respectively. Chronic use of systemic corticosteroids was discontinued in 35% of eligible patients versus 15% of noneligible patients.ConclusionIn Belgium, omalizumab is mostly initiated in uncontrolled asthma patients who are nonadherent to ICSs + LABAs. Omalizumab decreases hospitalisations and the use of systemic corticosteroids, but at a high cost. Careful management of patients with difficult-to-treat asthma should be a priority before prescribing omalizumab.

SMART and as-needed therapies in mild-to-severe asthma: a network meta-analysis

2020 ◽  
Vol 56 (3) ◽  
pp. 2000625 ◽  
Author(s):  
Paola Rogliani ◽  
Beatrice Ludovica Ritondo ◽  
Josuel Ora ◽  
Mario Cazzola ◽  
Luigino Calzetta
Keyword(s):  
Severe Asthma ◽  
Treatment Option ◽  
Low Dose ◽  
Therapeutic Option ◽  
Meta Analysis ◽  
Specific Treatment ◽  
High Dose ◽  
Asthmatic Patients ◽  
The Impact ◽  
Medium Dose

To date, there are no network meta-analyses comparing the impact of as-needed treatments in asthma, including the single maintenance and reliever therapy (known as “SMART” or “MART”; for simplicity, SMART will be used hereafter) and the use of inhaled corticosteroid (ICS)/long-acting β2-agonist (LABA) combination exclusively on an as-needed basis. Therefore, we performed a systematic review and network meta-analysis concerning the efficacy and safety of SMART and as-needed therapies in asthma. Data from 32 096 asthmatic patients were extracted from 21 studies, lasting from 6 to 12 months. In adult mild-to-moderate asthmatic patients low-dose SMART and as-needed low-dose ICS/LABA combination were significantly (relative effect <0.78; p<0.05) more effective than the other as-needed therapies in reducing the risk of exacerbation, and both were ranked as the first treatment option reaching the first quartile of the surface under the cumulative ranking curve analysis (SUCRA). In adult moderate-to-severe asthmatic patients, low-dose to medium-dose SMART and high-dose ICS/LABA+as-needed short-acting β2-agonist were equally effective in reducing the risk of severe asthma exacerbation (p>0.05), although only low- to medium-dose SMART was ranked as the first treatment option (first SUCRA quartile). Overall, these treatments were well tolerated, and effective also on lung function and disease control. This study supports SMART and as-needed therapies as a suitable therapeutic option for asthma, by providing the most effective positioning of each specific treatment according to the disease severity.

Dual biologic therapy in a patient with severe asthma and other allergic disorders

2021 ◽  
Vol 14 (5) ◽  
pp. e242211
Author(s):  
Joshua Ray Caskey ◽  
David Kaufman
Keyword(s):  
Severe Asthma ◽  
Inhaled Corticosteroids ◽  
Chronic Idiopathic Urticaria ◽  
High Dose ◽  
Dramatic Improvement ◽  
Eosinophilic Asthma ◽  
Severe Eosinophilic Asthma ◽  
Systemic Corticosteroids ◽  
Acute Exacerbations ◽  
H1 Antihistamines

Severe asthma is very difficult to manage in many individuals, and systemic corticosteroids are often used to prevent or manage acute exacerbations. Furthermore, comorbid allergic conditions may render standard therapies inadequate. A 51-year-old man presented with severe eosinophilic asthma requiring nearly constant oral corticosteroid usage despite using high-dose inhaled corticosteroids and secondary asthma controllers. His condition was complicated by aspirin-exacerbated respiratory disease, including severe nasal polyposis, chronic rhinosinusitis, as well as chronic idiopathic urticaria. Mepolizumab was initiated and led to dramatic improvement of asthma over 6 months. However, he continued to experience exacerbations of chronic idiopathic urticaria not responsive to H1-antihistamines. Omalizumab was added, and the patient’s urticaria attained marked improvement with only an occasional breakthrough rash. Dual biologic therapies can be a unique and useful steroid-sparing treatment option for patients with uncontrolled severe asthma and chronic idiopathic urticaria.

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