Some indications for depot methylprednisolone for asthma or other severe allergic disease

Corticosteroid-dependent asthma is asthma of such severity that function of the patient cannot be maintained without long-term corticosteroid therapy. Occasionally, the optimal alternative day single-dose prednisone regimen that is preferable is not possible because of the inability of patients to comply with such a regimen. We describe cases in which we have to advise depot methylprednisolone to prevent potentially fatal asthma or vasculitis, although this type of therapy is suboptimal in terms of avoiding sustained corticosteroid levels in tissue, adrenal cortical suppression, and potential side effects. The decision to use depot corticosteroids was made after exhausting other alternatives and considerting the risk and benefit ratio.