Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 6;4(4):100202.
doi: 10.1016/j.opresp.2022.100202. eCollection 2022 Oct-Dec.

[Use of systemic glucocorticoids for the treatment of severe asthma: Spanish Multidisciplinary Consensus]

[Article in Spanish]
Javier Domínguez-Ortega  1   2 , Julio Delgado Romero  3 , Xavier Muñoz Gall  2   4 , Amparo Marco  5 , Marina Blanco-Aparicio  6
Affiliations

[Use of systemic glucocorticoids for the treatment of severe asthma: Spanish Multidisciplinary Consensus]

[Article in Spanish]
Javier Domínguez-Ortega et al. Open Respir Arch. .

Abstract
in English, Spanish

Background and aim: Since their effectiveness was initially demonstrated, oral corticosteroids (OCS) have been routinely used to treat asthma. We now know that their usage is linked to the development of side effects such osteoporosis and adrenal insufficiency. This is an observational study based on Delphi methodology. The questionnaire was divided into 4 sections: OCS generalities, maintenance treatment, short-term treatment, and adverse events.

Materials and methods: Two rounds of a 68-item questionnaire were completed by a panel of 48 allergists and pneumologists.

Results: Definitions were agreed upon, as was the proper use of OCS in the treatment of severe asthma. The experts agreed that the use of OCS should be minimized as much as possible and that in the event of maintenance treatments, a slow and progressive tapering strategy should be used. They also emphasized the importance of standardizing the technique for measuring the amount of SCG delivered in both cases.

Conclusions: This consensus document attempts to bring together scientifically supported suggestions from specialists in the management of asthma to reduce the use of OCS in Spain.

Antecedentes y objetivo: Los glucocorticoides sistémicos (GCS) se han utilizado ampliamente para tratar el asma desde que se describió por primera vez su eficacia en esta enfermedad. Actualmente sabemos que su uso está asociado con la aparición de efectos adversos (EA), como la osteoporosis o la insuficiencia suprarrenal. Este es un estudio observacional basado en la metodología Delphi. El cuestionario constaba de 4 bloques principales: generalidades de los GCS; tratamiento de mantenimiento; tratamiento en ciclos cortos, y EA.

Materiales y métodos: Un panel de 48 expertos profesionales alergólogos y neumólogos respondieron a 2 rondas de un cuestionario de 68 enunciados.

Resultados: Se consensuaron definiciones y hubo acuerdos sobre el uso apropiado de los GCS en el tratamiento del asma grave. Los expertos consensuaron que el uso de los GCS se debe minimizar en lo posible y estuvieron de acuerdo en un esquema de retirada gradual y progresivo en caso de terapias de mantenimiento. Además, destacaron la necesidad de estandarizar el procedimiento de control de la medida de GCS administrado tanto en ciclos cortos como en terapias de mantenimiento a fin de controlar mejor la carga acumulada de los pacientes que reciben dicho tratamiento y evitar la aparición de EA.

Conclusiones: Este documento de consenso pretende aunar las recomendaciones de los expertos en el manejo del asma respaldadas por la evidencia científica con el objetivo de impulsar la reducción en el uso de GCS en el ámbito español.

Keywords: Asthma; Consensus; Delphi; Glucocorticoids; Side effects; Treatment withdrawal.

PubMed Disclaimer

Figures

None
Graphical abstract
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Holgate S.T., Wenzel S., Postma D.S., Weiss S.T., Renz H., Sly P.D. Asthma. Nat Rev Dis Primers. 2015;1(1):15025. - PMC - PubMed
    1. The global Asthma Report. [Consultado 1 FE 2021]. Disponible en: http://www.globalasthmareport.org/
    1. Soriano J.B., Kendrick P.J., Paulson K.R., Gupta V., Abrams E.M., Adedoyin R.A., et al. Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2020;8(6):585–596. - PMC - PubMed
    1. Soriano J.B., Rabe K.F., Vermeire P.A. Predictors of poor asthma control in European adults. J Asthma. 2003;40(7):803–813. - PubMed
    1. GINA2020. Global Initiative for Asthma. Glopbal Strategy for Asthma Managment and Prevention, 2020 [consultado 15 Mar 2021]. Disponible en: www.ginasthma.org

Publication types

LinkOut - more resources