The following is a summary of “Improving systemic corticosteroid stewardship in asthma” published in the November 2022 issue of Respiratory by Busse et al.

Philip Hench, Edward Kendall, and Tadeus Reichstein were awarded the Nobel Prize in Medicine in 1950 for their discovery of cortisone as a therapy for inflammatory illnesses. This achievement was recognized by the granting of the Nobel Prize in Chemistry in the same year. This development was also very important in increasing the number of treatment choices that were accessible to manage inflammation. 

After receiving cortisone treatment from Dr. Hench at the Mayo Clinic, a patient who suffered from severe and excruciating rheumatoid arthritis [1] was pain-free, no longer required the use of a wheelchair, and was walking within four days. Dr. Hench attributed the patient’s recovery to the use of cortisone. [1] The allegedly “miraculous” effects of cortisone were verified in rheumatoid arthritis in 1956 [2, 3], and the following year, they were extended to other disorders as well, including status asthmaticus. When it came to the treatment of asthma, a brand new era had just begun. However, because the development of major adverse effects was linked to the extended use of systemic cortisone, there are now questions regarding the safety of the medicine over the long term. 

As a direct result of this, back then, procedures were devised to minimize the unavoidable adverse effects of cortisone treatment, and these efforts continue to be a key focus for a significant number of asthma patients today.