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Oral corticosteroids linked to increased adverse event profile in patients with asthma

A recent study published in the journal Respiratory Research suggests an association between oral prednisolone use and increased incidence of adverse events among adult patients with asthma. Incidence of infections, gastrointestinal, neuropsychiatric, ocular, cardiovascular, metabolic and bone-related complications was significantly higher in users of oral prednisolone.

Researchers used data from the UK-based Clinical Practice Research Datalink and conducted a series of 11 cohort studies, each with a nested case-control analysis. Each cohort included between 165,900 and 269,368 patients with asthma, of whom between 836 and 16,192 developed an outcome of interest. For nested case-control studies, the majority of cases were matched to at least 1 control.

In the cohort analysis, current use of prednisolone was associated with significantly increased incidence of all study outcomes. After adjusting for confounders, current use vs no use of prednisolone was associated with increased incidence of all outcomes. Strongest association was observed between increased risk for severe infection (OR 2.16; 95% CI, 2.05-2.27). Increase in risk was observed for peptic ulcer, affective disorders, and cataract at higher doses, whereas the risk for herpes zoster, cardiovascular events, diabetes mellitus type 2 and bone-related conditions increased marginally. Prednisolone use was not associated with risk for glaucoma, chronic kidney disease or hypertension.

The authors commented, “This is the first study providing absolute and relative frequencies of potential corticosteroid-related complications among patients with asthma who used or did not use oral corticosteroids”. They emphasise the need for developing new treatments with better safety profile for patients with severe asthma.


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