Abstrakt

Low-dose oral glucocorticosteroids (OCS) are the mainstay of the treatment for several diffuse parenchymatous lung diseases, e.g. sarcoidosis, hypersensitivity alveolitis, some forms of the idiopathic interstitial pneumonias. Most asthma patients are well-controlled with inhalative corticoster- oids and if needed with additional long-acting bronchodilators. However, severe persistent asthma needs – by definition – OCS, which should be prescribed in the minimum effective dose to minimize side effects. Unlike disease modifying antirheumatic drugs (DMARD's) in respiratory medicine beyond corticosteroids no other evidence-based anti-inflammatory treatments are available. Most of the severe asthma patients can be controlled with a low-dose corticosteroid therapy that is a daily dose of 7.5 mg or less. In asthma several patients need this dose divided in two parts: the standard early morning and a second early afternoon dose since both the maximum of asthmatic inflammatory activity and the nadir of the bronchial width emerge between 2 – 4 a.m. For suppression of this inflammatory activity the ingestion of one third of the daily dose in severe patients with nocturnal asthma at 3 pm is recommended. It is worth mentioning that only a few of the recommendations according to the dose, duration and tapering of an oral corticosteroid treatment in respiratory disease is based on high-grade evidence. For osteoporosis prophylaxis 1000 mg calcium and 800 mg vitamin D is recommended.

Autoreninformation

Autoren

• P. Kardos

Abteilungen

• Gemeinschaftspraxis und Zentrum für Allergologie, Pneumologie, Schlafmedizin, Klinik Maingau vom Roten Kreuz, Frankfurt am Main

Adresse

Dr. med. P. Kardos
Gemeinschaftspraxis und Zentrum für Allergologie, Pneumologie, Schlafmedizin
an der Klinik Maingau vom Roten Kreuz
Scheffelstrasse 33
D-60318 Frankfurt am Main
Email: [email protected]

Citation