Abstract
Glucocorticoids are used in the treatment of inflammatory diseases, including asthma. Their efficacy and incumbent profile of adverse effects are well established. On occasion, practitioners encounter asthmatic patients who are difficult to control despite standard glucocorticoid therapy. These individuals may present with persistent nocturnal symptoms, exercise intolerance, peak flow variability and spirometric evidence of poor control. Many of these patients demonstrate an apparent resistance to standard and even aggressive glucocorticoid interventions. Consequently, these patients continue to experience severe airway disease and, often, also experience concurrent adverse effects of therapy.
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