The use of systemic corticosteroids in asthma management in Latin American countries
The stepwise treatment approach recommended by the Global Initiative for Asthma (GINA) includes systemic corticosteroids (SCS) suggested as a final step if asthma is severe and/or difficult to treat. Yet, despite the effectiveness of SCS, they are also associated with potentially irreversible advers...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | World Allergy Organization Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1939455123000200 |
| _version_ | 1797831029322416128 |
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| author | Jorge F. Maspero, MD, FCCP, FAAAAI Alvaro A. Cruz, MD, PhD Cesar Fireth Pozo Beltran, MD Abraham Ali Munive, MD Felicia Montero-Arias, MD Ramses Hernandez Pliego, MD Hisham Farouk, BCPS, MScPharm |
| author_facet | Jorge F. Maspero, MD, FCCP, FAAAAI Alvaro A. Cruz, MD, PhD Cesar Fireth Pozo Beltran, MD Abraham Ali Munive, MD Felicia Montero-Arias, MD Ramses Hernandez Pliego, MD Hisham Farouk, BCPS, MScPharm |
| author_sort | Jorge F. Maspero, MD, FCCP, FAAAAI |
| collection | DOAJ |
| description | The stepwise treatment approach recommended by the Global Initiative for Asthma (GINA) includes systemic corticosteroids (SCS) suggested as a final step if asthma is severe and/or difficult to treat. Yet, despite the effectiveness of SCS, they are also associated with potentially irreversible adverse outcomes such as type 2 diabetes, adrenal suppression, and cardiovascular disease. Based on recent data indicating that the risk of developing these conditions can increase after as few as 4 short-term (burst) courses of SCS, even patients with mild asthma who receive SCS occasionally for exacerbations are also at risk of these events. As a result, recent updates by GINA and the Latin American Thoracic Society recommend decreasing SCS use by optimizing administration of non-SCS therapies and/or increasing the use of alternatives, such as biologic agents. Recent and ongoing studies characterizing treatment patterns among patients with asthma have revealed alarming trends suggesting the widespread overuse of SCS around the world. In Latin America, asthma prevalence is approximately 17%, and data suggest that the majority of patients have uncontrolled disease. In this review, we summarize currently available data on asthma treatment patterns in Latin America, which indicate that SCS are prescribed to 20–40% of patients with asthma considered to be well controlled and over 50% of patients with uncontrolled disease. We also offer potential strategies to help reduce SCS use for asthma in everyday clinical practice. |
| first_indexed | 2024-04-09T13:45:31Z |
| format | Article |
| id | doaj.art-0af85c17e8af442cb551960143c285e8 |
| institution | Directory Open Access Journal |
| issn | 1939-4551 |
| language | English |
| last_indexed | 2024-04-09T13:45:31Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Allergy Organization Journal |
| spelling | doaj.art-0af85c17e8af442cb551960143c285e82023-05-09T04:05:03ZengElsevierWorld Allergy Organization Journal1939-45512023-04-01164100760The use of systemic corticosteroids in asthma management in Latin American countriesJorge F. Maspero, MD, FCCP, FAAAAI0Alvaro A. Cruz, MD, PhD1Cesar Fireth Pozo Beltran, MD2Abraham Ali Munive, MD3Felicia Montero-Arias, MD4Ramses Hernandez Pliego, MD5Hisham Farouk, BCPS, MScPharm6Fundación Cidea Allergy and Respiratory Research Unit, Buenos Aires, Argentina; Corresponding author. Allergy and Respiratory Medicine, Fundacion Cidea Paraguay 2035, 3º Cuerpo 2º Subsuelo C1121ABE, Ciudad Aut. de Buenos Aires, ArgentinaFundação ProAR and Federal University of Bahia, Bahia, BrazilHospital General con Especialidades Juan Maria Salvatierra, La Paz Baja California Sur, MexicoFundación Neumológica Colombiana, Bogotá, ColombiaHospital Clínica Bíblica, Santa Ana, San José, Costa RicaRespiratory and Immunology, International Region, AstraZeneca, United Arab EmiratesRespiratory and Immunology, International Region, AstraZeneca, United Arab EmiratesThe stepwise treatment approach recommended by the Global Initiative for Asthma (GINA) includes systemic corticosteroids (SCS) suggested as a final step if asthma is severe and/or difficult to treat. Yet, despite the effectiveness of SCS, they are also associated with potentially irreversible adverse outcomes such as type 2 diabetes, adrenal suppression, and cardiovascular disease. Based on recent data indicating that the risk of developing these conditions can increase after as few as 4 short-term (burst) courses of SCS, even patients with mild asthma who receive SCS occasionally for exacerbations are also at risk of these events. As a result, recent updates by GINA and the Latin American Thoracic Society recommend decreasing SCS use by optimizing administration of non-SCS therapies and/or increasing the use of alternatives, such as biologic agents. Recent and ongoing studies characterizing treatment patterns among patients with asthma have revealed alarming trends suggesting the widespread overuse of SCS around the world. In Latin America, asthma prevalence is approximately 17%, and data suggest that the majority of patients have uncontrolled disease. In this review, we summarize currently available data on asthma treatment patterns in Latin America, which indicate that SCS are prescribed to 20–40% of patients with asthma considered to be well controlled and over 50% of patients with uncontrolled disease. We also offer potential strategies to help reduce SCS use for asthma in everyday clinical practice.http://www.sciencedirect.com/science/article/pii/S1939455123000200Systemic corticosteroidsSevere asthmaLatin AmericaBiological productsAdverse effects |
| spellingShingle | Jorge F. Maspero, MD, FCCP, FAAAAI Alvaro A. Cruz, MD, PhD Cesar Fireth Pozo Beltran, MD Abraham Ali Munive, MD Felicia Montero-Arias, MD Ramses Hernandez Pliego, MD Hisham Farouk, BCPS, MScPharm The use of systemic corticosteroids in asthma management in Latin American countries World Allergy Organization Journal Systemic corticosteroids Severe asthma Latin America Biological products Adverse effects |
| title | The use of systemic corticosteroids in asthma management in Latin American countries |
| title_full | The use of systemic corticosteroids in asthma management in Latin American countries |
| title_fullStr | The use of systemic corticosteroids in asthma management in Latin American countries |
| title_full_unstemmed | The use of systemic corticosteroids in asthma management in Latin American countries |
| title_short | The use of systemic corticosteroids in asthma management in Latin American countries |
| title_sort | use of systemic corticosteroids in asthma management in latin american countries |
| topic | Systemic corticosteroids Severe asthma Latin America Biological products Adverse effects |
| url | http://www.sciencedirect.com/science/article/pii/S1939455123000200 |
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