Page 70 - Škrgat, Sabina, ed. 2023. Severe Asthma Forum - Monitoring and Treatable Traits in Severe Asthma. Koper: University of Primorska Press. Severe Asthma Forum, 2
P. 70
Safety and the most of them are more willing to ac-
cept some degree of lung function deteriora-
severe asthma forum 2: severe asthma - monitoring and treatable traits in severe asthma The results of randomized and real-life stud- tion compared to other outcomes (worsening
ies as well as experience in everyday clinical of symptoms, quality of life) when reducing
practice confirms that the safety profile of all OCS dose47. If the patients show a good re-
five biologics is very good. Side effects dur- sponse to biologics, it is recommended to con-
ing treatment with biologics in clinical stud- sider reducing OCS carefully and gradually.
ies were mild in most cases for all approved Reduction of corticosteroids in cases of a good
biologics. Sometimes they did not differ from response to biologics should be gradually as-
the side effects seen in patients receiving pla- sessed at intervals of several months. Stud-
cebo. The most common side effects were low- ies have shown that it sometimes takes a long
er respiratory tract infection, nasopharyngi- time for a dose of corticosteroids to be signifi-
tis, sinusitis, worsening of asthma, headache, cantly reduced or completely ruled out48.
pain or reaction at the injection site and ar-
thralgia14–21,36–39. Allowing a reduction in OCS therapy by
half or complete exclusion is the main criteri-
Common immediate side effects after on for response to treatment. It is also recom-
administration are local pain and discom- mended to try to stop taking other additional
fort at the injection site. Very rarely, anaphy- medicines, but to maintain a medium dose of
lactic reactions occur during administration, inhaled corticosteroid at all times.
which is why drugs should be given under the
supervision of health professionals and pa- According to the new GINA guidelines,
tients should be monitored for some time af- the introduction of a biologic is recommend-
ter administration14. Reports of such adverse ed before the use of systemic corticosteroids in
reactions state that they have been successful- order to prevent their side effects. In patients
ly treated. with uncontrolled severe asthma who are not
eligible for b iologics or those who do not re-
Effects of biologics on corticosteroids spond to biologic therapy, OCS treatment
treatment is still an important alternative to achieving
control. Patients who do not respond to b io-
One of the most important effects of biolog- logics may also not respond to systemic cor-
ic therapy is the possibility to exclude or re- ticosteroids1.
duce the dose of corticosteroids in patients
who need them for disease control. The conse- Effects of biologics on lung function
quences of long-term of systemic corticoster-
oids use are widely recognized. Price and cow- Severe asthma that is refractory to treatment
orkers recently investigated that patients with usually significantly affects lung function and
asthma prescribed oral corticosteroid (OCS) the use of biologic drugs often significant-
had a significantly increased risk of osteopo- ly improves it. In some patients, the changes
rosis and osteoporotic fracture, pneumonia, may be permanent due to airway remodeling
cardio and cerebrovascular diseases, cata- and result in fixed airway obstruction.
ract, sleep apnea, renal impairment, depres-
sion and anxiety, type 2 diabetes and weight Pulmonary function in patients with se-
gain45. The short courses of systemic corticos- vere asthma is very important, but during bi-
teroids are much safer, but are still associat- ologic treatment a certain degree of impair-
ed with increased risk of adverse events46. In ment of pulmonary function is considered
project ROSA the majority physicians have more acceptable compared to other outcomes
a favorable perception towords using bio- such as exacerbations, symptoms and quality
logical agents whenever patients are eligible of life if oral corticosteroids may be excluded
or reduced47.
cept some degree of lung function deteriora-
severe asthma forum 2: severe asthma - monitoring and treatable traits in severe asthma The results of randomized and real-life stud- tion compared to other outcomes (worsening
ies as well as experience in everyday clinical of symptoms, quality of life) when reducing
practice confirms that the safety profile of all OCS dose47. If the patients show a good re-
five biologics is very good. Side effects dur- sponse to biologics, it is recommended to con-
ing treatment with biologics in clinical stud- sider reducing OCS carefully and gradually.
ies were mild in most cases for all approved Reduction of corticosteroids in cases of a good
biologics. Sometimes they did not differ from response to biologics should be gradually as-
the side effects seen in patients receiving pla- sessed at intervals of several months. Stud-
cebo. The most common side effects were low- ies have shown that it sometimes takes a long
er respiratory tract infection, nasopharyngi- time for a dose of corticosteroids to be signifi-
tis, sinusitis, worsening of asthma, headache, cantly reduced or completely ruled out48.
pain or reaction at the injection site and ar-
thralgia14–21,36–39. Allowing a reduction in OCS therapy by
half or complete exclusion is the main criteri-
Common immediate side effects after on for response to treatment. It is also recom-
administration are local pain and discom- mended to try to stop taking other additional
fort at the injection site. Very rarely, anaphy- medicines, but to maintain a medium dose of
lactic reactions occur during administration, inhaled corticosteroid at all times.
which is why drugs should be given under the
supervision of health professionals and pa- According to the new GINA guidelines,
tients should be monitored for some time af- the introduction of a biologic is recommend-
ter administration14. Reports of such adverse ed before the use of systemic corticosteroids in
reactions state that they have been successful- order to prevent their side effects. In patients
ly treated. with uncontrolled severe asthma who are not
eligible for b iologics or those who do not re-
Effects of biologics on corticosteroids spond to biologic therapy, OCS treatment
treatment is still an important alternative to achieving
control. Patients who do not respond to b io-
One of the most important effects of biolog- logics may also not respond to systemic cor-
ic therapy is the possibility to exclude or re- ticosteroids1.
duce the dose of corticosteroids in patients
who need them for disease control. The conse- Effects of biologics on lung function
quences of long-term of systemic corticoster-
oids use are widely recognized. Price and cow- Severe asthma that is refractory to treatment
orkers recently investigated that patients with usually significantly affects lung function and
asthma prescribed oral corticosteroid (OCS) the use of biologic drugs often significant-
had a significantly increased risk of osteopo- ly improves it. In some patients, the changes
rosis and osteoporotic fracture, pneumonia, may be permanent due to airway remodeling
cardio and cerebrovascular diseases, cata- and result in fixed airway obstruction.
ract, sleep apnea, renal impairment, depres-
sion and anxiety, type 2 diabetes and weight Pulmonary function in patients with se-
gain45. The short courses of systemic corticos- vere asthma is very important, but during bi-
teroids are much safer, but are still associat- ologic treatment a certain degree of impair-
ed with increased risk of adverse events46. In ment of pulmonary function is considered
project ROSA the majority physicians have more acceptable compared to other outcomes
a favorable perception towords using bio- such as exacerbations, symptoms and quality
logical agents whenever patients are eligible of life if oral corticosteroids may be excluded
or reduced47.
