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While the adverse consequences of long-term use are widely recognised, there appears to be a perception in the medical community that short courses of SCS are safe. Limited but growing evidence in the literature suggests that even very brief dosing periods (3\u20137\u2005days) of SCS are enough to cause significantly negative outcomes for patients. Short courses of SCS are associated with increased risk of adverse events including loss of bone density, hypertension and gastrointestinal ulcers\/bleeds, in addition to serious impacts on mental health. Strategies to improve asthma control are recommended, including: 1) as-needed combination therapies in mild asthma; 2) risk factor reduction; 3) improving adherence\/inhaler technique; 4) earlier initiation of add-on therapies; 5) use of biologics in appropriate patients; 6) development of new therapies to better control the disease; and 7) widespread education of the medical community. We propose that patients and primary care physicians should consider a cumulative SCS dose of 1\u2005g per year as a highly relevant and easy-to-recall threshold.<\/jats:p>","DOI":"10.1183\/16000617.0151-2019","type":"journal-article","created":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T12:25:14Z","timestamp":1585916714000},"page":"190151","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":106,"title":["Short-course systemic corticosteroids in asthma: striking the balance between efficacy and safety"],"prefix":"10.1183","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9728-9992","authenticated-orcid":false,"given":"David","family":"Price","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Castro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Bourdin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Fucile","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Altman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2020,4,3]]},"reference":[{"key":"2024102403442556000_29.155.190151.1","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/S2213-2600(17)30293-X","article-title":"Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990\u20132015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"5","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2024102403442556000_29.155.190151.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(58)91385-0"},{"key":"2024102403442556000_29.155.190151.3","first-page":"482","article-title":"Effects of cortisone on bronchial asthma and hay fever occurring in subjects sensitive to ragweed pollen","volume":"25","author":"Carryer","year":"1950","journal-title":"Proc Staff Meet Mayo Clin"},{"key":"2024102403442556000_29.155.190151.4","first-page":"803","article-title":"CONTROLLED trial of effects of cortisone acetate in status asthmaticus; report to the Medical Research Council by the subcommittee on clinical trials in asthma","volume":"271","year":"1956","journal-title":"Lancet"},{"key":"2024102403442556000_29.155.190151.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-015905"},{"key":"2024102403442556000_29.155.190151.6","first-page":"CD000195","article-title":"Corticosteroids for preventing relapse following acute exacerbations of asthma","volume":"1","author":"Rowe","year":"2001","journal-title":"Cochrane Database Syst Rev"},{"key":"2024102403442556000_29.155.190151.7","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00900-2019"},{"key":"2024102403442556000_29.155.190151.8","unstructured":"Global Initiative for Asthma . 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