TY - JOUR T1 - Consequences of long-term OCS therapy and its side effects in severe asthma in adults – A focused review of the impact data in the literature JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00703-2018 SP - 1800703 AU - Timm Volmer AU - Timo Effenberger AU - Christoph Trautner AU - Roland Buhl Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/early/2018/09/06/13993003.00703-2018.abstract N2 - This review provides an overview of the role of long-term treatment of severe asthma with oral corticosteroids (OCS) and its associated side effects in adults. It is based on a systematic literature search conducted in MEDLINE, EMBASE, and the Cochrane Library to identify relevant studies. After a short overview of severe asthma and its treatment we present studies showing a dose-response relationship in asthmatic patients treated with OCS and then consider by organ systems the undesired effects demonstrated in clinical and epidemiological studies in patients with OCS-dependent asthma. It was found that the risk of developing various OCS-related complications, including infections, diabetes and osteoporosis as well as psychiatric disorders, was higher for patients with long-term exposure to OCS compared with control groups. Studies also showed a significant increase in health care resource utilisation due to OCS treatment. Therefore, it is incumbent on every clinician to carefully weigh the potential benefit - preventing loss of asthma control - against this risk before opting to prescribe long-term OCS therapy. Effective corticosteroid-sparing strategies must be used and one should aim at short-term use with the lowest effective dose and start tapering as soon as possible until OCS therapy is terminated.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Volmer reports grants from Teva Pharmaceutical Industries Ltd., during the conduct of the study; personal fees from Teva Pharmaceutical Industries Ltd., outside the submitted work.Conflict of interest: Dr. Effenberger reports grants from Teva Pharmaceutical Industries Ltd., during the conduct of the study; personal fees from Teva Pharmaceutical Industries Ltd., outside the submitted work.Conflict of interest: Prof. Dr. Trautner reports grants from Teva Pharmaceutical Industries Ltd., during the conduct of the study; personal fees from Teva Pharmaceutical Industries Ltd., outside the submitted work.Conflict of interest: Prof. Dr. Buhl reports grants from Teva Pharmaceutical Industries Ltd., during the conduct of the study; personal fees from Teva Pharmaceutical Industries Ltd., outside the submitted work. ER -