CHEST 2019 — Asthma: repeated corticosteroid courses linked to higher rate of complications in adults


  • Keren Landman, MD
  • Conference Reports
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Takeaway

  • Repeated courses of systemic corticosteroids (SCS) were linked to an increased risk of complications in asthmatic adults.

Why this matters

  • Physicians may reduce SCS risks by keeping careful medication histories and optimizing other therapy when possible.

Study design

  • Retrospective analysis of adults with persistent asthma enrolled in IBM MarketScan Research Databases (2003-2016).
  • Patients were propensity-matched on relevant characteristics.
  • Index date was defined as date of first SCS prescription or, if no SCS prescribed during study period, asthma diagnosis date.
  • Chronic complications of SCS were compared between controls (no SCS claims in study period) and groups defined by number of SCS claims in postindex date year:
    • 10,096 high-frequency users (≥4 claims).
    • 76,690 low-frequency users (1-3 claims).
  • Funding: AstraZeneca.

Key results

  • High-frequency users were more likely than controls to have had a complication.
  • At 1 and 5 years postindex, high-frequency users had:
    • more complications than controls (15% and 33%, respectively).
    • a higher proportion with >1 complication vs controls (28% vs 67% at 1 year, 67% vs 56% at 5 years).
  • In years 3-5 postindex, low-frequency users had more complications than controls, most commonly hypertension, obesity, gastrointestinal bleeds, and diabetes.

Limitations

  • Retrospective analysis.
  • Claims data do not guarantee full courses of prescribed medications were taken.