Severe Asthma Patients: Can We Really Wean Them off of Oral Corticosteroids

Opinion statement We aim to find the role of systemic corticosteroids and if viable to reduce or discontinue its use in severe asthma patients. Asthma, as a chronic inflammatory disease, is considered an important public health problem worldwide. Particularly, severe asthma has the biggest and most important impact both for patients and institutions. Despite the advance understanding of severe asthma pathophysiology and the development and availability of more biological therapies, the use of systemic corticosteroids is still a mainstay in the treatment of severe asthma and they are widely used to manage asthma exacerbations, although it has been proven that short- and long-term use of systemic corticosteroids is associated with important complications. The new therapeutic approaches based on the use of biological therapy aim at reducing or discontinuing systemic corticosteroid use without having exacerbations or worsening of the disease. Most biological therapies proved to be helpful in reducing or discontinuing the use of corticosteroids; however, this has not been standardized. It is necessary to continue working on the study and the implementation of better strategies to optimize the use of systemic corticosteroid in severe asthma patients. Here, we review systemic corticosteroid use evidence and reduction with different biological therapies in patients with severe asthma.