ABSTRACT
The vast majority of patients achieve adequate asthma control with regular
inhaled corticosteroids and bronchodilators. A subgroup will require additional therapy or combinations of treatment, but a small percentage of
patients have refractory disease with poorly controlled symptoms, recurrent
exacerbations, and/or persistent airflow obstruction despite such treatment
(1). The regular use of systemic corticosteroids may be required to achieve
improvements in asthma control in these patients. Additionally, systemic
corticosteroids remain the treatment of choice for the management of acute
severe exacerbations of asthma. This chapter will discuss the pharmacology
and mechanisms of action of systemic corticosteroids, review the evidence for their clinical effectiveness and adverse effects, and offer recommendations
for their use in asthma.
