Korean J Intern Med.  2012 Jun;27(2):143-148. 10.3904/kjim.2012.27.2.143.

Steroid Response in Refractory Asthmatics

  • 1Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. jas877@schmc.ac.kr


Inhaled glucocorticosteroids are currently the most effective anti-inflammatory controller medications for treating persistent asthma. The efficacies of glucocorticoids include reducing asthma symptoms, reducing exacerbation frequency, improving quality of life, improving lung function, decreasing airway hyperresponsiveness, controlling airway inflammation, and reducing mortality. However, the treatment response to glucocorticosteroids in asthmatics varies, and certain subtypes of asthma, such as refractory asthma, respond poorly to high-dose inhaled glucocorticoid and systemic steroids. The medical costs of treating refractory asthmatics represent about 50% of the total healthcare cost for asthma. A thorough understanding of the mechanisms of glucocorticoid action, patient responses to glucocorticoids, and steroid resistance observed in refractory asthmatics is necessary for the targeted development of therapeutic drugs. This review discusses the characteristics of severe refractory asthmatics and the mechanisms of steroid response and resistance in asthma treatment.


Glucocorticoids; Drug resistance; Asthma

MeSH Terms

Administration, Inhalation
Anti-Asthmatic Agents/administration & dosage/adverse effects/*therapeutic use
Anti-Inflammatory Agents/administration & dosage/adverse effects/*therapeutic use
Asthma/diagnosis/*drug therapy/physiopathology
Drug Resistance
Glucocorticoids/administration & dosage/adverse effects/*therapeutic use
Lung/*drug effects/physiopathology
Severity of Illness Index
Treatment Outcome
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