Tonya Winders, M.B.A
President and CEO, Asthma and Allergy Network
Five to 10 percent of the 26.5 million Americans with asthma are believed to have severe asthma. Severe or difficult-to-control asthma is a type of asthma that can be particularly debilitating, which negatively affects patients’ quality of life. Sudden symptoms can be fatal.
There is no cure for asthma, but a range of conventional and advanced medications can help control symptoms. When conventional treatments do not control symptoms, it can be an indicator of severe or difficult-to-control asthma.
Oral corticosteroids (OCS) is a common treatment for severe asthma. This medication is designed to treat and prevent airway inflammation and swelling, as well as decrease mucus. OCS are typically prescribed to treat an asthma flare for five to seven days, or until symptoms improve.
Taking more than two courses — or bursts — of OCS in a 12-month period is an indicator of severe or difficult-to-control asthma.
It’s important to know that using OCS is associated with serious health risks. Even low-dose, short-term use of OCS can result in serious health problems such as glaucoma, elevated blood pressure, fluid retention, weight gain, and problems with memory, mood, and behavior. Long-term use is associated with cataracts, infections, and osteoporosis, and it can trigger or worsen high blood sugar levels in patients with diabetes, cause bruising, and slow the healing process for wounds.
A U.S. study in 2017 that involved patients with asthma and other diseases revealed that short-term OCS use doubled their risk for fracture, tripled the risk for blood clots, and had a five-fold increased risk for sepsis.
Inhaled versus oral corticosteroids
Doctors typically prescribe inhaled corticosteroids as a daily asthma-controller medication before prescribing OCS. These medications reduce and prevent airway swelling, involve fewer side effects, and result in a much lower steroid exposure compared to OCS.
While OCS can be an important tool in managing severe asthma in certain cases, usage should always be carefully monitored by a qualified asthma specialist or a primary care provider with asthma expertise. Oral corticosteroids often need to be given during an acute attack to prevent ED visit and hospitalizations, so make sure you speak with your healthcare provider before stopping any OCS.
If you or a loved one has asthma symptoms that are impacting quality of life, schedule an appointment with your asthma doctor and discuss new treatment options.