Difficult to control asthma

13) Steroid sparing immunosuppressant medicines

There are some people whose asthma control can only be achieved using steroid tablets. Steroids can have side effects especially when used long term. Doctors try to keep the dose of steroids as low as possible in to order to reduce the risk of side effects.

To assist in keeping the steroid dose as low as possible some people may be considered for additional therapy in order to reduce the need for steroids. Some people will be offered Omalizumab as a steroid sparing drug. Other drugs include Methotrexate, Ciclosporin and Gold.
Steroid sparing medicines:

  • Are rarely used.
  • Can all decrease long term steroid requirements but all have significant side effects.
  • They have no persisting effect when they are stopped and people’s response to the drugs is very variable.
  • Risks and benefits should be carefully discussed and monitored.
  • Treatment should be in a specialist centre with experience of using these medicines.

What do they do?
Immunosuppressant’s are used to enhance the effects of steroids.

  • They alter the body’s immune response making it easier for the steroids to work.
  • This means a lower dose of steroids can be used and the risk of long term effects is reduced.
  • They are usually given as a trial (up to 3 months) to see if they help.
  • Male and female patients must be agreeable to using effective contraception (birth control methods) before receiving methotrexate.
  • If you are taking other medication (it is important your doctor knows all the medication you are taking including herbal or homoeopathic medicines and those bought over the counter).