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Oral steroids like prednisone should only be used as maintenance medication in the most severe cases of asthmawith no history of exacerbation, and then only for 7–8 months. Patients with asthma without or with moderate or severe disease should only be on inhaled corticosteroids for a period of several months, then stopped for as long as is clinically necessary and after the need for any reevaluation of effectiveness has been confirmed.5 Adverse Reactions In a prospective trial of 13,868 participants with asthma (11,827 with chronic obstructive pulmonary disease [COPD], 12,738 with acute asthma/sinusitis [AAS], and 7,068 with no asthma), the incidence and duration of asthma exacerbations and the frequency and severity of allergic reactions were significantly reduced in asthma-only group compared with controls. In the asthma-only group, an estimated 52% fewer participants developed acute bronchospasm symptoms and more than half of these patients (54%) experienced a milder asthma exacerbation than participants in COPD (52%). In short-term clinical trials, the incidence and severity of asthma exacerbations with the use of asthma medications has not been reported.6–8 In an earlier systematic review of adverse reactions to intranasal steroid medications, the adverse reactions were not identified but were described in one of the included studies.9 In summary, in recent decades, a significant number of patients with asthma have begun to take steroid medications as a new and more effective treatment option. With the use of low-cost oral corticosteroid medications, and with the increased awareness of the importance of using oral steroids to treat asthma attacks, the likelihood of having a severe allergic reaction to such oral medications is significantly reduced. Although the use of oral steroids for asthma exacerbations has recently increased, it was unclear whether use of these medications for asthma is associated with an increased incidence and duration of adverse symptoms and asthma-related deaths. Our study suggests that oral steroids increase the prevalence of asthma-related adverse events. The incidence of severe allergic reactions was significantly higher in the asthma-only group (52%) compared with the asthma-COPD (33%) and patients in the asthma-AAS (41%) groups. These results do not support the use of oral steroids for asthma. In summary, the evidence on the use of oral steroids for asthma is mixed. In our study, the incidence of severe allergic reactions to oral steroids is significantly higher in the asthma-only group than in asthma-COPD patients, but similar to the incidence of asthma- Similar articles: