The burden of systemic corticosteroid use in asthma management in Asia

Respirology. 2023 Aug;28(8):744-757. doi: 10.1111/resp.14533. Epub 2023 Jun 10.


For most patients, asthma can be effectively managed using inhaled medications. However, patients who have severe and/or uncontrolled asthma, or who experience exacerbations, may require systemic corticosteroids (SCSs) to maintain asthma control. Although SCS are highly effective in this regard, even modest exposure to these medications can increase the risk for long-term, adverse health outcomes, such as type 2 diabetes, renal impairment, cardiovascular disease and overall mortality. Clinical and real-world data from studies investigating asthma severity, control and treatment practices around the globe have suggested that SCS are overused in asthma management, adding to the already substantial healthcare burden experienced by patients. Throughout Asia, although data on asthma severity, control and SCS usage are limited and vary widely among countries, available data strongly suggest a pattern of overuse consistent with the broader global trend. Coordinated changes at the patient, provider, institutional and policy levels, such as increasing disease awareness, promoting better adherence to treatment guidelines and increasing availability of safe and effective alternatives to SCS, are likely necessary to reduce the SCS burden for patients with asthma in Asia.

Keywords: Asia; asthma; biological products; guideline adherence; policy; risk factors; steroids.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents* / therapeutic use
  • Asia / epidemiology
  • Asthma* / therapy
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans


  • Adrenal Cortex Hormones
  • Anti-Asthmatic Agents