Prolonged corticosteroid therapy in chronic asthma.

Abstract

Though the value of corticosteroids in controlling acute episodes of bronchial asthma has been proved beyond reasonable doubt (Medical Research Council, 1956a ; Walton, 1956; Thursby-Pelham and Kennedy, 1958), the place of these agents in the treatment of chronic asthma still remains an unsolved problem and, at times, a matter of fierce controversy (Herxheimer, 1955 ; Medical Research Council, 1956b; Brock bank et al., 1957). A corticosteroid preparation administered for 7 to 10 days to a patient with chronic asthma will often provide considerable or even complete relief of wheeze and dyspnoea, but the effect is temporary and symptoms recur with monotonous regularity at varying intervals after each course of treatment. Often in these eases a clinician, in desperation, resorts to continuous cortico steroid therapy on a long-term basis ; in many instances he is persuaded to adopt this policy by patients who have already experienced the dramatic but tantalizingly short-lived relief afforded by brief courses of treatment. Such patients are exposed to the very real danger of the side-effects so commonly encountered with prolonged corticosteroid therapy. The clinician's dilemma is to decide whether the benefits of treatment outweigh the risks.