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The burden of systemic corticosteroid use in asthma management in Asia |
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| Authors: | Raja Dhar Chin Kook Rhee Diahn-Warng Perng Koichi Fukunaga Mary Sau-Man Ip Siwasak Juthong Mariko Siyue Koh Jing Li Shubham Sharma Wiwien Heru Wiyono |
| Affiliation: | 1. Department of Pulmonology, CK Birla Group of Hospitals, Kolkata, West Bengal, India;2. Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of South Korea, Seoul, South Korea;3. Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Contribution: Conceptualization (equal), Investigation (equal), Methodology (equal), Supervision (equal), Writing - original draft (equal), Writing - review & editing (equal);4. Department of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan Contribution: Conceptualization (equal), Investigation (equal), Methodology (equal), Supervision (equal), Writing - original draft (equal), Writing - review & editing (equal);5. Department of Medicine, University of Hong Kong, Hong Kong, China;6. Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand Contribution: Conceptualization (equal), Investigation (equal), Methodology (equal), Supervision (equal), Writing - original draft (equal), Writing - review & editing (equal);7. Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, Singapore;8. Allergy and Clinical Immunology Department, State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China Contribution: Conceptualization (equal), Investigation (equal), Methodology (equal), Supervision (equal), Writing - original draft (equal), Writing - review & editing (equal);9. Heart and Lung Transplant Unit, Yashoda Hospitals, Secunderabad, India Contribution: Conceptualization (equal), Investigation (equal), Methodology (equal), Supervision (equal), Writing - original draft (equal), Writing - review & editing (equal);10. Department of Pulmonology and Respiratory Medicine Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia Contribution: Conceptualization (equal), Investigation (equal), Methodology (equal), Supervision (equal), Writing - original draft (equal), Writing - review & editing (equal) |
| Abstract: | For most patients, asthma can be effectively managed using inhaled medications. However, patients who have severe and/or uncontrolled asthma, or who experience exacerbations, may require systemic corticosteroids (SCSs) to maintain asthma control. Although SCS are highly effective in this regard, even modest exposure to these medications can increase the risk for long-term, adverse health outcomes, such as type 2 diabetes, renal impairment, cardiovascular disease and overall mortality. Clinical and real-world data from studies investigating asthma severity, control and treatment practices around the globe have suggested that SCS are overused in asthma management, adding to the already substantial healthcare burden experienced by patients. Throughout Asia, although data on asthma severity, control and SCS usage are limited and vary widely among countries, available data strongly suggest a pattern of overuse consistent with the broader global trend. Coordinated changes at the patient, provider, institutional and policy levels, such as increasing disease awareness, promoting better adherence to treatment guidelines and increasing availability of safe and effective alternatives to SCS, are likely necessary to reduce the SCS burden for patients with asthma in Asia. |
| Keywords: | Asia asthma biological products guideline adherence policy risk factors steroids |