What is the typical place of therapy for oral corticosteroids in asthma management?

In the management of asthma, oral corticosteroids are typically utilized as add-on therapy for patients with severe asthma that is not sufficiently controlled with other treatments. This places them at Step 5 in the treatment guidelines, which is reserved for individuals who require high-dosage inhaled corticosteroids along with additional therapy to achieve adequate asthma control.

Step 5 is indicative of situations where the disease severity necessitates more advanced therapeutic strategies, and oral corticosteroids can help reduce inflammation more effectively and manage symptoms in these difficult-to-treat cases. Using them in this manner allows for improved management of chronic symptoms and helps prevent exacerbations.

While oral corticosteroids can be prescribed during acute exacerbations of asthma to quickly gain control over severe symptoms, their primary role in a stepwise asthma management approach is as an add-on for those with persistent severe asthma, rather than as a first-line treatment or solely during acute episodes.