Severe Steroid Dependent Asthma

[WayneinMaine]

My wife is 54 and was diagnosed with asthma 8 years ago. Besides her regular pulmonologist, she has seen three other specialists, including a visit to National Jewish in 1998. She has been taking both oral and IV corticosteroids daily since the beginning, and she averages a hospital admission every two weeks; every week since early Dec. Her doctor's term for her condition is "severe end stage asthma with marked steroid insensitivity." She had also been on a course of methotrexate for over a year that produced no significant benefit. She has extreme side effects from high steroid use. Without going into a lot of details about her case, I would like to know if there have been any studies of patients with similar asthma problems where the only treatment seems to be high doses of corticosteroids and nebs to relieve the asthma exacerbations.

[lefseisgr8]

I have been steiroid dependent asthmatic since l988, I have been on Methotrexate 7 yrs, it has gotten me off cortisone other
than the need for sinus infection/asthma during the winter months.  I take zurtec, singulair, Advair 2xday, 25mg of Methotrexate injected weekly, and Xolair 2 shots once a mo, for nine months now, just stopped daily maintance of combivent, next will decrease singulair.  Xolair is amazing, whenever I walk any distance, I felt so much fatigue in my thighs, since Xolair that has improved greatly, much more oxygen than before. I also take PROTONEX for acid reflex, that caused so much morning asthma, this med is exceptional!  I doctor with North West Asthma and Allergy in Seattle.  206-527-1200.  Many of the doctors are on the faculty of the University of Washington School of Medicine, also Children's Hospital.  Exceptional clinic!!  After a doctor told me there was nothing more that could be done,I did amazing amount of research looking for the clinic that was most aggressive, it has been 10 yrs now, I am im much better control than ever dreamed of! So very gtateful for my doctors there!  Other medical issues I deal with are Gaves Disease, Synthroid, Diabetes, Metforman 5/l00mg a day and /Glyberid 10 mg 2/2 x day, Arthritis,Celebrex 100 mg daily,
Stasis Dermatisis/compression stockings 20/30. HRT Esterderm Patch. Colesteral, zocor l0 mg daily. Severe headaches, Nortriptoline 50 mg's at bedtime.  I am very faithful with my meds, it keeps me in exceptional control.  When I was 5 I had polio, left me with minimal effects.  Good Luck, take it a day at a time!

[reader1]

I agree that another thorough eval would be helpful.  I have been on Xolair for 4 months.  I understand it can take up to a year for Xolair to take full effect.  However, I have not taken any steroids, antibiotics or albuterol since January 1.  I know of a number of people who have been able to decrease their steroid use significantly since starting Xolair, which has only been available since July or August of last year.

[National Jewish]

Your wife clearly has severe asthma.  However I would be very reluctant to use the term "end stage".  I trust that you have also made every effort to eliminate environmental factors that could worsen her asthma.  She might be a candidate for clinical trials to test new drugs at a university medical center in your area.

Since it has been 6 years since your wife was seen at National Jewish Medical and Research Center, I recommend that she consider coming back for reevaluation.  New treatments have become available since 1998.  One example is Xolair