The Story of Corticosteroids in Asthma

Asthma is a common respiratory disease affecting patients of all ages and races. Up to the middle of the 20th century there was scarce knowledge regarding the biology of the disease and asthma was a potentially lethal disease with very limited therapeutic options. The introduction of corticosteroids revolutionized the management of asthma and improved the lives of millions of patients. Parental and later oral administration was the first treatment with remarkable effects on asthma symptoms and exacerbations but led to serious systemic effects. The invention of inhaled forms of corticosteroids that had minimal systemic absorption and adverse reactions, the enhancement of their efficacy by LABAs and the understanding of asthma pathophysiology were only a few of the significant advances in asthma management over the last 60 years. In this review we present these life-changing advances in asthma treatment, focusing οn the evolutionary role of corticosteroids.