William W. Busse
European Respiratory Journal 2022 60: 2201440; DOI: 10.1183/13993003.01440-2022
The discovery of cortisone for inflammatory diseases was a Nobel Laureate achievement for Philip Hench, Edward Kendall and Tadeus Reichstein in 1950, and one that changed therapeutic options to regulate inflammation [1]. When Dr Hench at the Mayo Clinic administered cortisone to a patient with severe, crippling rheumatoid arthritis [1], she was pain-free, no longer wheelchair bound, and walking in four days! The apparently “miraculous” effects of cortisone were confirmed in rheumatoid arthritis and extended to other diseases, including status asthmaticus in 1956 [2, 3]. A new era in asthma management had begun. The development of major side-effects with prolonged use of systemic cortisone, however, raised concerns about its long-term safety. Consequently, strategies to minimise the inevitable side-effects from cortisone began then and remain a priority today for many asthma patients.
New evidence in this issue of the ERJ indicates that the previous duration and cumulative dose of oral corticosteroids influence the likelihood to achieve corticosteroid tapering after initiating IL-5/IL5R biologics for severe asthma https://bit.ly/3RONCRL
Conflict of interest: W.W. Busse reports consultation/advisory board work for Sanofi, Regeneron, GlaxoSmithKline, AstraZeneca, Genentech and Novartis.