Q: What do people with asthma need to know about taking oral corticosteroids (OCS)?

Purvi Parikh, MD: Oral corticosteroids are often needed in asthma care. They are most commonly prescribed when asthma is uncontrolled or flaring up. However, some people with very severe asthma may need to take oral corticosteroids more regularly.

Oral corticosteroids do come with a lot of side effects. They can cause weight gain, diabetes, high blood pressure, bone loss, thinning of the skin, eye cataracts or bone loss, among other side effects, and it’s important to minimize use as much as possible.

Many people don’t realize that even one or two courses of oral corticosteroids over a whole year is enough to be considered too much – and also a sign that your asthma is not well controlled. If you are taking this amount or more, it’s a good idea to talk with your doctor and discuss other medication options.

Fortunately, there are new asthma medications that help patients move away from oral corticosteroid use altogether, or at least minimize it significantly. These medications are called biologics, and they target specific parts of the immune system that control asthma, rather than the entire immune system as oral corticosteroids do.

Each of the biologics – omalizumab, reslizumab, mepolizumab, benralizumab and dupilumab – target different types of asthma and their dosage frequency varies. For that reason, it’s important to talk with your doctor in a Shared Decision Making approach and discuss whether biologics are right for you.

Purvi Parikh, MD, is a board-certified allergist and immunologist with Allergy and Asthma Associates of Murray Hill and New York University School of Medicine in New York City. She is also a member of the American College of Allergy, Asthma and Immunology.

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