Reducing Tolerance for SABA and OCS towards the Extreme Ends of Asthma Severity
Asthma is a heterogeneous chronic inflammatory airway disease that imposes a great burden on public health worldwide. In the past two years, fundamental changes have been addressed in the Global Initiative for Asthma (GINA) recommendations focusing mainly on the management of mild and severe asthma....
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/3/504 |
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| author | Petros Bakakos Konstantinos Kostikas Stelios Loukides Michael Makris Nikolaos G. Papadopoulos Paschalis Steiropoulos Stavros Tryfon Eleftherios Zervas |
| author_facet | Petros Bakakos Konstantinos Kostikas Stelios Loukides Michael Makris Nikolaos G. Papadopoulos Paschalis Steiropoulos Stavros Tryfon Eleftherios Zervas |
| author_sort | Petros Bakakos |
| collection | DOAJ |
| description | Asthma is a heterogeneous chronic inflammatory airway disease that imposes a great burden on public health worldwide. In the past two years, fundamental changes have been addressed in the Global Initiative for Asthma (GINA) recommendations focusing mainly on the management of mild and severe asthma. The use of as-needed treatment containing inhaled corticosteroids plus fast-acting bronchodilators (either short or long-acting formoterol) in mild asthma has dominated the field, and both randomized and real-world studies favor such an approach and associate it with fewer exacerbations and good asthma control. At the same time, the effort to diminish the use of oral steroids (OCS) as maintenance treatment in severe asthma was substantially accomplished with the initiation of treatment with biologics. Still, these options are available at the moment only for severe asthmatics with a T2-high endotype, and relevant studies on biologics have yielded, as a primary outcome, the reduction or even cessation of OCS. Accordingly, OCS should be considered as a temporary option, mainly for the treatment of asthma exacerbations, and as a maintenance treatment only for a minority of patients with severe asthma, after ensuring good inhaler technique, modification of all possible contributory factors and comorbidities, and optimized pharmacotherapy using all other add-on treatments including biologics in the armamentarium of anti-asthma medication. |
| first_indexed | 2024-03-09T13:37:54Z |
| format | Article |
| id | doaj.art-2c5a6d0b22764161b6522ab5ac57c154 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T13:37:54Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-2c5a6d0b22764161b6522ab5ac57c1542023-11-30T21:09:24ZengMDPI AGJournal of Personalized Medicine2075-44262022-03-0112350410.3390/jpm12030504Reducing Tolerance for SABA and OCS towards the Extreme Ends of Asthma SeverityPetros Bakakos0Konstantinos Kostikas1Stelios Loukides2Michael Makris3Nikolaos G. Papadopoulos4Paschalis Steiropoulos5Stavros Tryfon6Eleftherios Zervas71st University Department of Respiratory Medicine, National and Kapodistrian University of Athens, 157 72 Athens, GreeceRespiratory Medicine Department, School of Medicine, University of Ioannina, 451 10 Ioannina, Greece2nd University Department of Respiratory Medicine, National and Kapodistrian University of Athens, 157 72 Athens, GreeceAllergy Unit, 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, 157 72 Athens, GreeceAllergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 157 72 Athens, GreeceDepartment of Respiratory Medicine, Medical School, University General Hospital, Democritus University of Thrace, 691 00 Alexandroupolis, GreeceRespiratory Department of NHS, “G. Papanikolaou” General Hospital, 570 10 Thessaloniki, Greece7th Respiratory Department, Athens Chest Hospital “Sotiria”, 115 27 Athens, GreeceAsthma is a heterogeneous chronic inflammatory airway disease that imposes a great burden on public health worldwide. In the past two years, fundamental changes have been addressed in the Global Initiative for Asthma (GINA) recommendations focusing mainly on the management of mild and severe asthma. The use of as-needed treatment containing inhaled corticosteroids plus fast-acting bronchodilators (either short or long-acting formoterol) in mild asthma has dominated the field, and both randomized and real-world studies favor such an approach and associate it with fewer exacerbations and good asthma control. At the same time, the effort to diminish the use of oral steroids (OCS) as maintenance treatment in severe asthma was substantially accomplished with the initiation of treatment with biologics. Still, these options are available at the moment only for severe asthmatics with a T2-high endotype, and relevant studies on biologics have yielded, as a primary outcome, the reduction or even cessation of OCS. Accordingly, OCS should be considered as a temporary option, mainly for the treatment of asthma exacerbations, and as a maintenance treatment only for a minority of patients with severe asthma, after ensuring good inhaler technique, modification of all possible contributory factors and comorbidities, and optimized pharmacotherapy using all other add-on treatments including biologics in the armamentarium of anti-asthma medication.https://www.mdpi.com/2075-4426/12/3/504asthmamild asthmasevere asthmashort-acting beta-agonistsoral corticosteroids |
| spellingShingle | Petros Bakakos Konstantinos Kostikas Stelios Loukides Michael Makris Nikolaos G. Papadopoulos Paschalis Steiropoulos Stavros Tryfon Eleftherios Zervas Reducing Tolerance for SABA and OCS towards the Extreme Ends of Asthma Severity Journal of Personalized Medicine asthma mild asthma severe asthma short-acting beta-agonists oral corticosteroids |
| title | Reducing Tolerance for SABA and OCS towards the Extreme Ends of Asthma Severity |
| title_full | Reducing Tolerance for SABA and OCS towards the Extreme Ends of Asthma Severity |
| title_fullStr | Reducing Tolerance for SABA and OCS towards the Extreme Ends of Asthma Severity |
| title_full_unstemmed | Reducing Tolerance for SABA and OCS towards the Extreme Ends of Asthma Severity |
| title_short | Reducing Tolerance for SABA and OCS towards the Extreme Ends of Asthma Severity |
| title_sort | reducing tolerance for saba and ocs towards the extreme ends of asthma severity |
| topic | asthma mild asthma severe asthma short-acting beta-agonists oral corticosteroids |
| url | https://www.mdpi.com/2075-4426/12/3/504 |
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