"Patient remodeling" as a consequence of uncontrolled and prolonged OCS use in severe asthma: how biologic therapy can reverse a dangerous trend

J Asthma. 2024 Jan;61(1):72-75. doi: 10.1080/02770903.2023.2241910. Epub 2023 Aug 24.

Abstract

Introduction: Asthma is a chronic inflammatory disease that can lead to airways remodeling. Despite their well-known side-effects, oral corticosteroids (OCS) continue to be used to reduce exacerbations and control asthma symptoms in many patients.

Case study: We describe two cases of uncontrolled severe asthma characterized by systemic clinical consequences of prolonged OCS use, such as diabetes, weight gain, and osteoporosis.

Results: Both patients were treated with Dupilumab. During follow-up both patients showed an improvement in asthma control and were able to gradually taper the OCS dose, thus reducing the clinical burden associated with hypercortisolism.

Conclusion: Dupilumab was able to control both the inflammatory-induced "airway remodeling" as well as the OCS-induced "patient remodeling".

Keywords: Bronchial asthma; dupilumab; oral corticosteroids; remodeling.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Asthmatic Agents* / adverse effects
  • Asthma* / diagnosis
  • Humans

Substances

  • Anti-Asthmatic Agents
  • Adrenal Cortex Hormones