[en] Oral corticosteroids (OCS) have been used for both maintenance and burst treatment of asthma since the 1950s owing to their beneficial effect on symptoms and exacerbations coupled with a historical lack of alternative therapies. Despite the current availability of well-tolerated and effective treatment with biologics, chronic OCS use remains high. This is of great concern because evidence suggests that a lifetime cumulative exposure even as low as 0.5 to 1.0 g prednisolone equivalent (about three to four bursts of OCS) significantly increases the risk of a wide range of acute and long-term adverse effects, some of which may not be fully reversible. Conversely, biologics have demonstrated a more favorable benefit-risk profile compared with OCS, while reducing exacerbations and improving symptom control. Here, we review the current situation, highlight the need for improved stewardship of OCS use, describe the cumulative and potentially irreversible toxicity seen with even short bursts of OCS, and discuss the role of biologics in minimizing their use. Finally, we provide our opinion on how maintenance OCS therapy in asthma can be relegated to history, with early patient risk evaluation to identify and measure biomarkers and/or clinical traits that may predict risk of future exacerbations, enabling proactive preventative intervention.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Schleich, Florence ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation > Physiologie humaine et physiologie de l'effort physique
Oppenheimer, John J; Department of Internal Medicine, UMDNJ Rutgers University School of Medicine, Newark, N.J
Brusselle, Guy; Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
Heaney, Liam G; Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
Busse, William W; Department of Medicine, University of Wisconsin School of Medicine, Madison, Wis
Lugogo, Njira L; Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Mich
Hanania, Nicola A; Section of Pulmonary, Critical Care, and Sleep Medicine, Baylor College of Medicine, Houston, Texas
Bonini, Matteo; Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy, National Health and Lung Institute (NHLI), Imperial College London, London, United Kingdom
Lommatzsch, Marek; Department of Pneumology, University of Rostock, Rostock, Germany
Chanez, Pascal; Department of Respiratory Diseases, Aix-Marseille Université, INSERM, INRAE, C2VN, Marseille, France
Vichiendilokkul, Anna; Clinical Science, GSK, Collegeville, Pennsylvania, Pa
Benson, Victoria S; Global Epidemiology, GSK, London, United Kingdom
Finney-Hayward, Tricia; Global Medical Affairs, GSK, London, United Kingdom
Howarth, Peter; Global Medical Affairs, GSK, London, United Kingdom
Israel, Elliot; Pulmonary and Critical Care Medicine, Allergy & Immunology, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
All authors contributed to the conception and interpretation of data for this review article in addition to reviewing it critically for important intellectual content and providing final approval of the version to be published. Editorial support in the form of writing assistance, including development of the initial draft from the author discussions, assembling tables and figures, collating authors' comments, grammatical editing and referencing, was provided by Hanna Mourad-Agha, PhD, at Fishawack Indicia Ltd, United Kingdom, part of Avalere Health, and was funded by GSK.
Benedek, T.G., History of the development of corticosteroid therapy. Clin Exp Rheumatol, 29(5 suppl 68), 2011 S-5-12.
Bakakos, P., Kostikas, K., Loukides, S., Makris, M., Papadopoulos, N.G., Steiropoulos, P., et al. Reducing tolerance for SABA and OCS towards the extreme ends of asthma severity. J Pers Med, 12, 2022, 504.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. Updated May 2024. Accessed March 6, 2025. https://www.ginasthma.org, 2024. (Accessed 6 March 2025)
National Heart, Lung, and Blood Institute. 2020 focused updates to the Asthma Management Guidelines: a report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol 146 (2020), 1217–1270.
Menzies-Gow, A.N., Tran, T.N., Stanley, B., Carter, V.A., Smolen, J.S., Bourdin, A., et al. Trends in systemic glucocorticoid utilization in the United Kingdom from 1990 to 2019: a population-based, serial cross-sectional analysis. Pragmat Obs Res 15 (2024), 53–64.
Burrage, W.S., Irwin, J.W., The role of cortisone in the treatment of severe bronchial asthma. N Engl J Med 248 (1953), 679–682.
Bleecker, E.R., Menzies-Gow, A.N., Price, D.B., Bourdin, A., Sweet, S., Martin, A.L., et al. Systematic literature review of systemic corticosteroid use for asthma management. Am J Respir Crit Care Med 201 (2020), 276–293.
Bloechliger, M., Reinau, D., Spoendlin, J., Chang, S.C., Kuhlbusch, K., Heaney, L.G., et al. Adverse events profile of oral corticosteroids among asthma patients in the UK: cohort study with a nested case-control analysis. Respir Res, 19, 2018, 75.
Haughney, J., Winders, T., Holmes, S., Chanez, P., Menzies-Gow, A., Kocks, J., et al. A charter to fundamentally change the role of oral corticosteroids in the management of asthma. Adv Ther 40 (2023), 2577–2594.
Price, D.B., Trudo, F., Voorham, J., Xu, X., Kerkhof, M., Ling Zhi Jie, J., et al. Adverse outcomes from initiation of systemic corticosteroids for asthma: long-term observational study. J Asthma Allergy 11 (2018), 193–204.
Brown, H.M., Treatment of chronic asthma with prednisolone; significance of eosinophils in the sputum. Lancet 2 (1958), 1245–1247.
Knowles, J.P., Difficulties in weaning in steroid treatment in asthma. Br Med J 2 (1961), 1396–1399.
Porsbjerg, C.M., Menzies-Gow, A.N., Tran, T.N., Murray, R.B., Unni, B., Audrey Ang, S.L., et al. Global variability in administrative approval prescription criteria for biologic therapy in severe asthma. J Allergy Clin Immunol Pract 10 (2022), 1202–1216.e23.
Chung, K.F., Wenzel, S.E., Brozek, J.L., Bush, A., Castro, M., Sterk, P.J., et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J 43 (2014), 343–373.
Bel, E.H., Wenzel, S.E., Thompson, P.J., Prazma, C.M., Keene, O.N., Yancey, S.W., et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N Engl J Med 371 (2014), 1189–1197.
Nair, P., Wenzel, S., Rabe, K.F., Bourdin, A., Lugogo, N.L., Kuna, P., et al. Oral glucocorticoid-sparing effect of benralizumab in severe asthma. N Engl J Med 376 (2017), 2448–2458.
Rabe, K.F., Nair, P., Brusselle, G., Maspero, J.F., Castro, M., Sher, L., et al. Efficacy and safety of dupilumab in glucocorticoid-dependent severe asthma. N Engl J Med 378 (2018), 2475–2485.
Brusselle, G.G., Koppelman, G.H., Biologic therapies for severe asthma. N Engl J Med 386 (2022), 157–171.
Blaiss, M., Bleecker, E.R., Jacob-Nara, J., Nair, R., Duh, M.S., Wang, Z., et al. Real-world effectiveness of dupilumab in patients with asthma: findings from the US ADVANTAGE study. Ann Allergy Asthma Immunol 132 (2024), 463–468 e1.
Braunstahl, G.J., Chlumsky, J., Peachey, G., Chen, C.W., Reduction in oral corticosteroid use in patients receiving omalizumab for allergic asthma in the real-world setting. Allergy Asthma Clin Immunol, 9, 2013, 47.
Chung, Y., Katial, R., Mu, F., Cook, E.E., Young, J., Yang, D., et al. Real-world effectiveness of benralizumab: results from the ZEPHYR 1 Study. Ann Allergy Asthma Immunol 128 (2022), 669–676 e6.
Hashimoto, S., Kroes, J.A., Eger, K.A., Mau Asam, P.F., Hofstee, H.B., Bendien, S.A., et al. Real-world effectiveness of reslizumab in patients with severe eosinophilic asthma - first initiators and switchers. J Allergy Clin Immunol Pract 10 (2022), 2099–2108.e6.
Pilette, C., Canonica, G.W., Chaudhuri, R., Chupp, G., Lee, F.E., Lee, J.K., et al. REALITI-A study: real-world oral corticosteroid-sparing effect of mepolizumab in severe asthma. J Allergy Clin Immunol Pract 10 (2022), 2646–2656.
Wechsler, M.E., Menzies-Gow, A., Brightling, C.E., Kuna, P., Korn, S., Welte, T., et al. Evaluation of the oral corticosteroid-sparing effect of tezepelumab in adults with oral corticosteroid-dependent asthma (SOURCE): a randomised, placebo-controlled, phase 3 study. Lancet Respir Med 10 (2022), 650–660.
Graff, S., Brusselle, G., Hanon, S., Sohy, C., Dupont, L., Peche, R., et al. Anti-interleukin-5 therapy is associated with attenuated lung function decline in severe eosinophilic asthma patients from the Belgian Severe Asthma Registry. J Allergy Clin Immunol Pract 10 (2022), 467–477.
Benson, V.S., George, M., Vichiendilokkul, A., Has OCS use for severe asthma in the US decreased in the last 10 years?. Poster PA1175 presented at the European Respiratory Society Congress, September 7-11, 2024 Vienna, Austria.
Menzies-Gow, A., Bafadhel, M., Busse, W.W., Casale, T.B., Kocks, J.W.H., Pavord, I.D., et al. An expert consensus framework for asthma remission as a treatment goal. J Allergy Clin Immunol 145 (2020), 757–765.
Chung, L.P., Upham, J.W., Bardin, P.G., Hew, M., Rational oral corticosteroid use in adult severe asthma: a narrative review. Respirology 25 (2020), 161–172.
Busse, W.W., Melén, E., Menzies-Gow, A.N., Holy Grail: the journey towards disease modification in asthma. Eur Respir Rev, 31, 2022, 210183.
Krings, J.G., Goss, C.W., Lew, D., Samant, M., McGregor, M.C., Boomer, J., et al. Quantitative CT metrics are associated with longitudinal lung function decline and future asthma exacerbations: results from SARP-3. J Allergy Clin Immunol 148 (2021), 752–762.
Soremekun, S., Heaney, L.G., Skinner, D., Bulathsinhala, L., Carter, V., Chaudhry, I., et al. Asthma exacerbations are associated with a decline in lung function: a longitudinal population-based study. Thorax 78 (2023), 643–652.
Tran, T.N., Heatley, H., Rowell, J., Chan, J.S.K., Bourdin, A., Chapaneri, J., et al. Longitudinal patterns of intermittent oral corticosteroid therapy for asthma in the United Kingdom. J Allergy Clin Immunol Glob, 3, 2024, 100225.
Dhar, R., Rhee, C.K., Perng, D.W., Fukunaga, K., Ip, M.S., Juthong, S., et al. The burden of systemic corticosteroid use in asthma management in Asia. Respirology 28 (2023), 744–757.
Maspero, J.F., Cruz, A.A., Beltran, C.F.P., Ali Munive, A., Montero-Arias, F., Hernandez, Pliego R., et al. The use of systemic corticosteroids in asthma management in Latin American countries. World Allergy Organ J, 16, 2023, 100760.
van Bragt, J., Adcock, I.M., Bel, E.H.D., Braunstahl, G.J., Ten Brinke, A., Busby, J., et al. Characteristics and treatment regimens across ERS SHARP severe asthma registries. Eur Respir J, 55, 2020, 1901163.
Jackson, D.J., Busby, J., Pfeffer, P.E., Menzies-Gow, A., Brown, T., Gore, R., et al. Characterisation of patients with severe asthma in the UK Severe Asthma Registry in the biologic era. Thorax 76 (2021), 220–227.
McDowell, P.J., McDowell, R., Busby, J., Eastwood, M.C., Patel, P.H., Jackson, D.J., et al. Clinical remission in severe asthma with biologic therapy: an analysis from the UK Severe Asthma Registry. Eur Respir J, 62, 2023, 2300819.
Mathioudakis, A.G., Tsilochristou, O., Adcock, I.M., Bikov, A., Bjermer, L., Clini, E., et al. ERS/EAACI statement on adherence to international adult asthma guidelines. Eur Respir Rev, 30, 2021, 210132.
Gurnell, M., Heaney, L.G., Price, D., Menzies-Gow, A., Long-term corticosteroid use, adrenal insufficiency and the need for steroid-sparing treatment in adult severe asthma. J Intern Med 290 (2021), 240–256.
Menzies-Gow, A., Gurnell, M., Heaney, L.G., Corren, J., Bel, E.H., Maspero, J., et al. Oral corticosteroid elimination via a personalised reduction algorithm in adults with severe, eosinophilic asthma treated with benralizumab (PONENTE): a multicentre, open-label, single-arm study. Lancet Respir Med 10 (2022), 47–58.
Menzies-Gow, A., Gurnell, M., Heaney, L.G., Corren, J., Bel, E.H., Maspero, J., et al. Adrenal function recovery after durable oral corticosteroid sparing with benralizumab in the PONENTE study. Eur Respir J, 60, 2022, 2103226.
Kyriakopoulos, C., Gogali, A., Markozannes, G., Kostikas, K., Biologic agents licensed for severe asthma: a systematic review and meta-analysis of randomised controlled trials. Eur Respir Rev, 33, 2024, 230238.
Schleich, F., Graff, S., Nekoee, H., Moermans, C., Henket, M., Sanchez, C., et al. Real-word experience with mepolizumab: does it deliver what it has promised?. Clin Exp Allergy 50 (2020), 687–695.
Schleich, F., Moermans, C., Seidel, L., Kempeneers, C., Louis, G., Rogister, F., et al. Benralizumab in severe eosinophilic asthma in real life: confirmed effectiveness and contrasted effect on sputum eosinophilia versus exhaled nitric oxide fraction - PROMISE. ERJ Open Res 9 (2023), 00383–2023.
Charriot, J., Maravic, M., Huguet, M., Vachier, I., Suehs, C., Bourdin, A., “Real-life” management of patients with severe asthma in the biologics era: can we do better?. World Allergy Organ J, 14, 2021, 100528.
Huang, D., Zhang, L., Liu, Y., Wang, J., Zhang, J., Baines, K.J., et al. Activated non-neuronal cholinergic system correlates with non-type 2 inflammation and exacerbations in severe asthma. Ann Allergy Asthma Immunol 133 (2024), 64–72.e4.
McDowell, P.J., Diver, S., Yang, F., Borg, C., Busby, J., Brown, V., et al. The inflammatory profile of exacerbations in patients with severe refractory eosinophilic asthma receiving mepolizumab (the MEX study): a prospective observational study. Lancet Respir Med 9 (2021), 1174–1184.
Pincus, A.B., Fryer, A.D., Jacoby, D.B., Mini review: Neural mechanisms underlying airway hyperresponsiveness. Neurosci Lett, 751, 2021, 135795.
Cazzola, M., Rogliani, P., Ora, J., Calzetta, L., Matera, M.G., Asthma and comorbidities: recent advances. Pol Arch Intern Med, 132, 2022, 16250.
Fokkens, W.J., Lund, V.J., Hopkins, C., Hellings, P.W., Kern, R., Reitsma, S., et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology 58 (2020), 1–464.
Brennan, V., Martin-Grace, J., Greene, G., Heverin, K., Mulvey, C., McCartan, T., et al. The contribution of oral and inhaled glucocorticoids to adrenal insufficiency in asthma. J Allergy Clin Immunol Pract 10 (2022), 2614–2623.
Sullivan, P.W., Ghushchyan, V.H., Globe, G., Schatz, M., Oral corticosteroid exposure and adverse effects in asthmatic patients. J Allergy Clin Immunol 141 (2018), 110–116.e7.
Waljee, A.K., Rogers, M.A., Lin, P., Singal, A.G., Stein, J.D., Marks, R.M., et al. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ, 357, 2017, j1415.
Lommatzsch, M., Brusselle, G.G., Canonica, G.W., Jackson, D.J., Nair, P., Buhl, R., et al. Disease-modifying anti-asthmatic drugs. Lancet 399 (2022), 1664–1668.
Blaiss, M., Oppenheimer, J., Corbett, M., Bacharier, L., Bernstein, J., Carr, T., et al. Consensus of an American College of Allergy, Asthma, and Immunology, American Academy of Allergy, Asthma, and Immunology, and American Thoracic Society workgroup on definition of clinical remission in asthma on treatment. Ann Allergy Asthma Immunol 131 (2023), 782–785.
Lommatzsch, M., Buhl, R., Canonica, G.W., Ribas, C.D., Nagase, H., Brusselle, G.G., et al. Pioneering a paradigm shift in asthma management: remission as a treatment goal. Lancet Respir Med 12 (2024), 96–99.
Majellano, E.C., Clark, V.L., Winter, N.A., Gibson, P.G., McDonald, V.M., Approaches to the assessment of severe asthma: barriers and strategies. J Asthma Allergy 12 (2019), 235–251.
Moermans, C., Brion, C., Bock, G., Graff, S., Gerday, S., Nekoee, H., et al. Sputum type 2 markers could predict remission in severe asthma treated with anti-IL-5. Chest 163 (2023), 1368–1379.
Shackleford, A., Heaney, L.G., Redmond, C., McDowell, P.J., Busby, J., Clinical remission attainment, definitions, and correlates among patients with severe asthma treated with biologics: a systematic review and meta-analysis. Lancet Respir Med 13 (2025), 23–34.
Hansen, S., Baastrup Søndergaard, M., von Bülow, A., Bjerrum, A.S., Schmid, J., Rasmussen, L.M., et al. Clinical response and remission in patients with severe asthma treated with biologic therapies. Chest 165 (2024), 253–266.
Stone, J.H., McDowell, P.J., Jayne, D.R.W., Merkel, P.A., Robson, J., Patel, N.J., et al. The glucocorticoid toxicity index: measuring change in glucocorticoid toxicity over time. Semin Arthritis Rheum, 55, 2022, 152010.
McDowell, P.J., Busby, J., Stone, J.H., Butler, C.A., Heaney, L.G., Longitudinal assessment of glucocorticoid toxicity reduction in patients with severe asthma treated with biologic therapies. J Allergy Clin Immunol Pract 13 (2025), 298–307.e10.
McDowell, P.J., Stone, J.H., Zhang, Y., Honeyford, K., Dunn, L., Logan, R.J., et al. Glucocorticoid toxicity reduction with mepolizumab using the Glucocorticoid Toxicity Index. Eur Respir J, 59, 2022, 2100160.
Perez-de-Llano, L., Scelo, G., Tran, T.N., Le, T.T., Fageras, M., Cosio, B.G., et al. Exploring definitions and predictors of severe asthma clinical remission after biologic treatment in adults. Am J Respir Crit Care Med 210 (2024), 869–880.
Broder, M.S., Raimundo, K., Ngai, K.M., Chang, E., Griffin, N.M., Heaney, L.G., Cost and health care utilization in patients with asthma and high oral corticosteroid use. Ann Allergy Asthma Immunol 118 (2017), 638–639.
Bleecker, E.R., Al-Ahmad, M., Bjermer, L., Caminati, M., Canonica, G.W., Kaplan, A., et al. Systemic corticosteroids in asthma: a call to action from World Allergy Organization and Respiratory Effectiveness Group. World Allergy Organ J, 15, 2022, 100726.
Calzetta, L., Aiello, M., Frizzelli, A., Bertorelli, G., Rogliani, P., Chetta, A., Oral corticosteroids dependence and biologic drugs in severe asthma: myths or facts? A systematic review of real-world evidence. Int J Mol Sci, 22, 2021, 7132.
Cataldo, D., Louis, R., Michils, A., Peche, R., Pilette, C., Schleich, F., et al. Severe asthma: oral corticosteroid alternatives and the need for optimal referral pathways. J Asthma 58 (2021), 448–458.
Lugogo, N., Mohan, A., Are we poised to change the trajectory of maintenance oral corticosteroid use in severe asthma in the age of biologics?. Chest 162 (2022), 4–5.
Suehs, C.M., Menzies-Gow, A., Price, D., Bleecker, E.R., Canonica, G.W., Gurnell, M., et al. Expert consensus on the tapering of oral corticosteroids for the treatment of asthma. A Delphi study. Am J Respir Crit Care Med 203 (2021), 871–881.
Agusti, A., Bel, E., Thomas, M., Vogelmeier, C., Brusselle, G., Holgate, S., et al. Treatable traits: toward precision medicine of chronic airway diseases. Eur Respir J 47 (2016), 410–419.
Heaney, L.G., Busby, J., Hanratty, C.E., Djukanovic, R., Woodcock, A., Walker, S.M., et al. Composite type-2 biomarker strategy versus a symptom-risk-based algorithm to adjust corticosteroid dose in patients with severe asthma: a multicentre, single-blind, parallel group, randomised controlled trial. Lancet Respir Med 9 (2021), 57–68.
Flores, M., Glusman, G., Brogaard, K., Price, N.D., Hood, L., P4 medicine: how systems medicine will transform the healthcare sector and society. Per Med 10 (2013), 565–576.
McDowell, P.J., Busby, J., Heaney, L.G., Asthma exacerbations in severe asthma: why systemic corticosteroids may not always be the best treatment option. Curr Treat Options Allergy 10 (2023), 53–63.
McDowell, P.J., Busby, J., Hanratty, C.E., Djukanovic, R., Woodcock, A., Walker, S., et al. Exacerbation profile and risk factors in a type-2-low enriched severe asthma cohort: a clinical trial to assess asthma exacerbation phenotypes. Am J Respir Crit Care Med 206 (2022), 545–553.
Korn, S., Howarth, P., Smith, S.G., Price, R.G., Yancey, S.W., Prazma, C.M., et al. Development of methodology for assessing steroid-tapering in clinical trials for biologics in asthma. Respir Res, 23, 2022, 45.
Lommatzsch, M., Virchow, J.C., Asthma remission: a call for a globally standardised definition. Lancet Respir Med 13 (2025), 2–3.
Castro, M., Zangrilli, J., Wechsler, M.E., Bateman, E.D., Brusselle, G.G., Bardin, P., et al. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials. Lancet Respir Med 3 (2015), 355–366.
Chupp, G.L., Bradford, E.S., Albers, F.C., Bratton, D.J., Wang-Jairaj, J., Nelsen, L.M., et al. Efficacy of mepolizumab add-on therapy on health-related quality of life and markers of asthma control in severe eosinophilic asthma (MUSCA): a randomised, double-blind, placebo-controlled, parallel-group, multicentre, phase 3b trial. Lancet Respir Med 5 (2017), 390–400.
Hanania, N.A., Alpan, O., Hamilos, D.L., Condemi, J.J., Reyes-Rivera, I., Zhu, J., et al. Omalizumab in severe allergic asthma inadequately controlled with standard therapy: a randomized trial. Ann Intern Med 154 (2011), 573–582.
Humbert, M., Beasley, R., Ayres, J., Slavin, R., Hébert, J., Bousquet, J., et al. Benefits of omalizumab as add-on therapy in patients with severe persistent asthma who are inadequately controlled despite best available therapy (GINA 2002 step 4 treatment): INNOVATE. Allergy 60 (2005), 309–316.
Menzies-Gow, A., Corren, J., Bourdin, A., Chupp, G., Israel, E., Wechsler, M.E., et al. Tezepelumab in adults and adolescents with severe, uncontrolled asthma. N Engl J Med 384 (2021), 1800–1809.
Pavord, I.D., Bel, E.H., Bourdin, A., Chan, R., Han, J.K., Keene, O.N., et al. From DREAM to REALITI-A and beyond: mepolizumab for the treatment of eosinophil-driven diseases. Allergy 77 (2022), 778–797.
Khatri, S., Moore, W., Gibson, P.G., Leigh, R., Bourdin, A., Maspero, J., et al. Assessment of the long-term safety of mepolizumab and durability of clinical response in patients with severe eosinophilic asthma. J Allergy Clin Immunol 143 (2019), 1742–1751 e7.
Korn, S., Bourdin, A., Chupp, G., Cosio, B.G., Arbetter, D., Shah, M., et al. Integrated safety and efficacy among patients receiving benralizumab for up to 5 years. J Allergy Clin Immunol Pract 9 (2021), 4381–4392.e4.
Maspero, J.F., Peters, A.T., Chapman, K.R., Domingo, C., Stewart, J., Hardin, M., et al. Long-term safety of dupilumab in patients with moderate-to-severe asthma: TRAVERSE continuation study. J Allergy Clin Immunol Pract 12 (2024), 991–997.e6.
Menzella, F., Fontana, M., Contoli, M., Ruggiero, P., Galeone, C., Capobelli, S., et al. Efficacy and safety of omalizumab treatment over a 16-year follow-up: when a clinical trial meets real-life. J Asthma Allergy 15 (2022), 505–515.
Menzies-Gow, A., Wechsler, M.E., Brightling, C.E., Korn, S., Corren, J., Israel, E., et al. Long-term safety and efficacy of tezepelumab in people with severe, uncontrolled asthma (DESTINATION): a randomised, placebo-controlled extension study. Lancet Respir Med 11 (2023), 425–438.
Murphy, K., Jacobs, J., Bjermer, L., Fahrenholz, J.M., Shalit, Y., Garin, M., et al. Long-term safety and efficacy of reslizumab in patients with eosinophilic asthma. J Allergy Clin Immunol Pract 5 (2017), 1572–1581.e3.
Chen, W., Tran, T.N., Sadatsafavi, M., Murray, R., Wong, N.C.B., Ali, N., et al. Impact of initiating biologics in patients with severe asthma on long-term oral corticosteroids or frequent rescue steroids (GLITTER): data from the International Severe Asthma Registry. J Allergy Clin Immunol Pract 11 (2023), 2732–2747.
Bagnasc, D., Bondi, B., Caminati, M., Nicola, S., Pini, L., Milanese, M., et al. Evaluation of clinical remission in best-performing severe asthmatic patients treated for three years with mepolizumab. Biomedicines, 12, 2024, 960.
Menzies-Gow, A., Canonica, G.W., Winders, T.A., Correia de Sousa, J., Upham, J.W., Fink-Wagner, A.H., A charter to improve patient care in severe asthma. Adv Ther 35 (2018), 1485–1496.
Menzies-Gow, A., Jackson, D.J., Al-Ahmad, M., Bleecker, E.R., Cosio Piqueras, F.B.G., Brunton, S., et al. A renewed charter: key principles to improve patient care in severe asthma. Adv Ther 39 (2022), 5307–5326.
Clarke, R., Burhan, H., Joplin, H., Arvanitis, R., Bliss, J., M30 Accelerating access to specialist care for asthma patients through innovative pathway transformation. Thorax 78 (2023), A278–A279.
Gleeson, P.K., Morales, K.H., Hvisdas, C., LaCava, A.F., Harhay, M.O., Rank, M.A., et al. Factors associated with asthma biologic prescribing and primary adherence among adults in a large health system. J Allergy Clin Immunol Pract 11 (2023), 1834–1842 e4.
Canonica, G.W., Domingo, C., Lavoie, K.L., Kaliasethi, A., Khan, S.Q., Majumdar, A., et al. Asthma patients' and physicians' perspectives on the burden and management of asthma: post-hoc analysis of APPaRENT 1 and 2 to assess predictors of treatment adherence. Respir Med, 227, 2024, 107637.
Bardin, P.G., Price, D., Chanez, P., Humbert, M., Bourdin, A., Managing asthma in the era of biological therapies. Lancet Respir Med 5 (2017), 376–378.
Varricchi, G., Ferri, S., Pepys, J., Poto, R., Spadaro, G., Nappi, E., et al. Biologics and airway remodeling in severe asthma. Allergy 77 (2022), 3538–3552.
Feuerstein, J.D., Ho, E.Y., Shmidt, E., Singh, H., Falck-Ytter, Y., Sultan, S., et al. AGA clinical practice guidelines on the medical management of moderate to severe luminal and perianal fistulizing Crohn's disease. Gastroenterology 160 (2021), 2496–2508.
