Clinical Summary

Intermittent Oral Corticosteroids Prescription Tied to Adverse Outcomes in Asthma

Vinod Rane, BS Pharm | Disclosures

Takeaway

A significant proportion of patients with asthma who received intermittent oral corticosteroids experienced a frequent prescribing pattern.
Increasing frequent patterns of intermittent oral corticosteroids prescription were associated with a higher risk of individual oral corticosteroids-related adverse outcomes, especially pneumonia and sleep apnoea.

Findings suggest that the use of intermittent oral corticosteroids should be minimised in the asthma management whenever possible.

This historical cohort study used data from the Optimum Patient Care Research Database and Clinical Practice Research Datalink GOLD (2008-2019).
A total of 476,167 patients (age, ≥4 years) with asthma who received intermittent oral corticosteroids were matched (1:1) with 476,167 patients with or without asthma who did not receive oral corticosteroids.
Funding: AstraZeneca.

Overall, 41.7%, 26.8% and 31.6% of patients had one-off, less frequent and frequent patterns of intermittent oral corticosteroids prescription, respectively.
Risk of any oral corticosteroids-related adverse outcomes increased with increasing frequent patterns of intermittent oral corticosteroids prescription (adjusted HR; 95% CI):
- one-off oral corticosteroids (1.19; 1.18 to 1.20);
- less frequent oral corticosteroids (1.35; 1.34 to 1.36); and
- frequent oral corticosteroids (1.42; 1.42 to 1.43).
This association was consistent across age, Global Initiative for Asthma treatment step, inhaled corticosteroid maintenance and short-acting beta 2-agonists reliever use.
Risk of oral corticosteroids-related adverse outcomes, especially pneumonia and sleep apnoea, increased with increasing frequent patterns of intermittent oral corticosteroids prescription.