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It is a great resource for medicine, cortisone. With its many derivatives, it allows you to face various situations in the best possible way and quickly. But we must always remember that we must not exaggerate, if it is not the doctor who says it. Especially for asthma sufferers.
The use of cortisone pills in the treatment of asthma goes hand in hand with poor health, as well as with high costs of managing side effects. To say this is a Doxa opinion poll on the use of oral corticosteroids in the treatment of asthma, according to which problems such as hypertension, osteoporosis and fractures, cataracts and glaucoma, diabetes and sleep disorders, are much more frequent in asthmatics receiving corticosteroids oral versus asthmatics who do not use them.
Possible effect on the efficacy of the Covid-19 vaccine?
“An extensive and inadequate use of oral cortisone must be avoided even more today, during the pandemic: above a dosage of 7.5-10 milligrams per day, the immunosuppressive effect of oral cortisone prevails and there is a risk of worst course of the infection, if you are infected with SARS-CoV-2, or a lower response to the vaccine if you have undergone the anti-Covid vaccination – says Francesco Blasi, scientific board of SANI, Director of Pneumology of the Ca ‘Granda Foundation Ospedale Maggiore Policlinico and Professor of Respiratory Diseases at the University of Milan – According to international guidelines, oral corticosteroids in asthma should only be used in acute crises; in case of severe asthma it is suggested to use them at the lowest possible dosages and as a second choice treatment “.
But let’s get back to the study. 63% of those who take cortisone by mouth suffer from multiple pathologies, if oral therapy is continuous the percentage rises to 73% and in 22% of cases the other diseases present are three or more. Unfortunately, there is not enough risk awareness: essential tests to recognize the side effects of cortisone, such as Computerized Bone Mineralometry (MOC), are prescribed to just 11% of those who use it, and, paradoxically, to 4% of those who are on continuous therapy. Furthermore, oral cortisone can be risky even and above all in the case of anti-Covid vaccination: above a dosage of 7.5-10 milligrams per day, in fact, the immunosuppressive effect of oral cortisone prevails over the anti-inflammatory one and there is a risk of lower response to the vaccine.
These recommendations are the basis of a social campaign to raise awareness on systemic cortisone damage, promoted by the SANI network, which brings together centers specialized in the treatment of severe asthma. To cope with the side effects due to improper use as a first choice therapy in severe asthma, an annual cost of 240 million euros is estimated, according to the most recent Italian study by the SANI network, which assessed the impact of corticosteroids in severe asthma. If severe asthma leaves you breathless, therefore, you must correctly perform the inhalation therapies prescribed by the doctor, to which only 13.8% of patients adhere, and resort to new therapies with biological drugs, effective and able to reduce the ‘use of cortisone, which therefore allow in the long term savings in the cost of treatments but above all for side effects.
Women at risk
“There are about 4 million Italians with asthma, mostly women over 60, of these about half a million are treated with oral cortisone even if with mild asthma, in a completely unjustified way. – explains Giorgio Walter Canonica, scientific board of SANI and professor of Respiratory Medicine at Humanitas University and Humanitas Clinical Institute of Milan.
Oral cortisone carries a high risk of adverse events, higher with increasing dosage and duration of treatment and therefore consistent in subjects with severe asthma. The data from the Doxa survey, conducted on about 300 patients and 300 doctors, confirm this: 63% of those who use cortisone orally suffer from multiple pathologies. Percentage that rises to 73% in those who follow continuous oral cortisone therapy for more than 6 months. Unfortunately, the risks are underestimated and not enough is even done to promptly intercept them: just 11% of patients treated with cortisone have been prescribed MOC to assess osteoporosis, five times more common in those who take oral cortisone “.
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