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A common treatment for asthma may cause long-term complications and side-effects.

Asthma is a common problem of the respiratory system.  The condition occurs when the airways between the nose, mouth and lungs become inflamed, produce excess mucous, and become constricted as a result.  When the airways narrow, breathing becomes difficult and patients experience tightness of the chest, wheezing, and shortness of breath.  The Asthma and Allergy Foundation of America reports one in 13 people experience asthma in the US.

The cause of asthma is often unknown.  Family history can play a big role, as can environmental triggers, allergies, and lung sensitivity caused by early childhood infections. For asthmatics, easier breathing comes with minimizing known triggers, and oftentimes with prescription drugs, including corticosteroids.

Depending on the unique presentation of each patient, long-term and short-term asthma medications can be prescribed.  A primary long-term treatment for asthma is inhaled corticosteroids.  Most people know someone who carries an inhaler with them for regular use.  An inhaler can deliver maintenance doses of a corticosteroid, or quick-acting bronchodilators like short-acting beta agonists—such as albuterol.

Some patients may also be prescribed corticosteroids in tablet form, like prednisone, to provide systemic relief from the inflammation that causes asthma flare-ups.

A study published in The Medical Journal of Australia looked at long-term impacts to patients prescribed oral corticosteroids, like prednisone tablets.  Researchers evaluated the prescription data of more than 120,000 patients between the years 2014 and 2018.  The result echoes earlier research results that suggest long-term use of corticosteroids offer a trade-off in health benefits.

The study author of the Australian research, Dr. John Upham notes, “Researchers found more than 25 per cent of those patients were more likely to have a chronic condition.” He adds, “Short courses of steroid tablets can be effective at treating asthma attacks in the short term, but it’s becoming clear that repeated use may cause significant long-term side-effects like diabetes, osteoporosis and cataracts.”

The study suggests regular use of inhalers can minimize the prescription of oral corticosteroids and reduce exposure to steroids.  That said, a 2011 Johns Hopkins study suggested long-term use of corticosteroids for treatment of chronic obstructive pulmonary disease (COPD) increased the risk of bone fractures in patients by 27 percent.

Until alternative forms of treatment are developed for asthma and other respiratory conditions, careful consultation with physicians may be the best way for patients to obtain the benefit of corticosteroids, without dramatically raising their risk for harmful side effects.

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