STEROID RESISTANT ASTHMA

Abstract

Individuals with steroid resistant asthma which was first described in 1968 are often the most difficult to manage asthmatic patients in that they have severe disease yet fail to respond to glucocorticoids. To make the diagnosis of steroid resistant asthma, the patient must fail to respond to a 7 to 14 days course of daily prednisolone as measured by less than 'a 15% im-provement in morning prebronchodilator FEV, fol-lowing the glucocorticoids course. Ongoing inflam-mation is thought to play a major role in the patho-genesis of steroid resistant asthma, and recent stud-ies have demonstrated diminished glucocorticoids re-ceptor to DNA binding as possible mechanisms for diminished glucocorticoids responsiveness. Alterna-tive asthma therapies, such as methotraxate, cyclosporine and intravenous gammaglobulin are of ten used in this group of asthmatic patient.