Expert consensus on oral corticosteroids stewardship for the treatment of severe asthma in the Middle East and Africa.

In the Middle East and Africa (MEA) region, overuse of oral corticosteroids (OCS) for asthma management, both as burst and maintenance therapy, poses a significant challenge. Gaps in knowledge regarding the need to taper OCS in patients with severe asthma and the use of OCS in comorbid conditions have been noted. OCS stewardship can help attain optimal and effective OCS tapering along with reducing OCS overuse and over-reliance. In this paper, we discuss current practices regarding the use of OCS in asthma, globally and in the MEA region. Expert recommendations for achieving OCS stewardship in the MEA region have also been presented. Regional experts recommend increasing awareness among patients about the consequences of OCS overuse, engaging community pharmacists, and educating primary healthcare professionals about the benefits of prompt appropriate referral. Innovative local referral tools like ReferID can be utilized to refer patients with asthma to specialist care. The experts also endorse a multidisciplinary team approach and accelerating access to newer medicines like biologics to implement OCS stewardship and optimize asthma care in the MEA region.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: MAA received advisory board and lecture honoraria from AstraZeneca, Sanofi, and GSK. AAZ received honoraria from GSK, AstraZeneca, Sanofi, and Novartis. HAA received speaker honoraria from AstraZeneca, Merck & Co., Inc., Servier Laboratories, and Menarini; received support for attending meetings and traveling from Cipla Ltd., and Servier Laboratories. MI received honoraria for lectures and support for attending meetings from AstraZeneca.
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