Patient, female, 72 years old. She has a history of asthma for more than 40 years and has been taking oral prednisone intermittently for more than 10 years. In the past 2 years, she needed to take 2 to 4 tablets daily even more, and had to be hospitalized repeatedly for asthma attacks when she reduced to less than 2 tablets. Long-term hormone use has caused complications such as osteoporosis and diabetes. After a thorough evaluation of her condition, we diagnosed hormone-dependent asthma. Due to the multiple complications caused by long-term hormone use, hormone use had to be reduced and hormone replacement therapy was decided. Along with inhaled sulforaphane, we prescribed her a drug with immunosuppressive effects, methotrexate, 4 tablets (10 mg) once a week. The patient was also asked to be actively followed up with close monitoring of liver and kidney function and blood routine. After 3 months of treatment, prednisone had been reduced to 1 tablet (5 mg) daily, and the condition was stable with no asthma attacks. Multiple monitoring of liver and kidney function and blood routine were normal. Hormone-dependent asthma is a refractory form of asthma that requires long-term oral hormones (e.g., prednisone) to maintain stable disease. As soon as the dosage is reduced or stopped, asthma attacks immediately and hospitalization is often required. Long-term use of hormones can lead to a variety of complications, such as osteoporosis and fractures, diabetes, and obesity. With the widespread use of inhaled hormones, many asthma patients have been freed from oral hormones and their asthma control status has improved significantly. However, there are still some patients with severe asthma in clinical practice who must use oral hormones to control their condition. The treatment of this kind of asthma has been a difficult problem in the field of asthma. Asthma is a chronic inflammatory disease of the airways, and the role of hormones is to control airway inflammation. In addition to hormones, some drugs with immunosuppressive effects, such as methotrexate, also have a role in controlling airway inflammation and are sometimes used clinically as an alternative to hormones as a treatment for refractory asthma. Because immunosuppressive drugs have certain side effects, such as bone marrow suppression (reduction of white blood cells), their application in asthma is greatly limited. However, we have experienced that for refractory hormone-dependent asthma, methotrexate can also be used cautiously with good results, and is safer with less side effects at less high doses. However, during the initial period of use, attention should be paid to monitoring blood routine, liver and kidney functions, etc. We also emphasize that it is important not to use these drugs blindly, but to be diagnosed and fully evaluated by an experienced asthma specialist to see if there is a need to use these drugs and if there are any contraindications to their use.