» Articles » PMID: 26819354

Comorbidity in Severe Asthma Requiring Systemic Corticosteroid Therapy: Cross-sectional Data from the Optimum Patient Care Research Database and the British Thoracic Difficult Asthma Registry

Overview
Journal Thorax
Date 2016 Jan 29
PMID 26819354
Citations 118
Authors
Affiliations
Soon will be listed here.
Abstract

Objective: To determine the prevalence of systemic corticosteroid-induced morbidity in severe asthma.

Design: Cross-sectional observational study.

Setting: The primary care Optimum Patient Care Research Database and the British Thoracic Society Difficult Asthma Registry.

Participants: Optimum Patient Care Research Database (7195 subjects in three age- and gender-matched groups)-severe asthma (Global Initiative for Asthma (GINA) treatment step 5 with four or more prescriptions/year of oral corticosteroids, n=808), mild/moderate asthma (GINA treatment step 2/3, n=3975) and non-asthma controls (n=2412). 770 subjects with severe asthma from the British Thoracic Society Difficult Asthma Registry (442 receiving daily oral corticosteroids to maintain disease control).

Main Outcome Measures: Prevalence rates of morbidities associated with systemic steroid exposure were evaluated and reported separately for each group.

Results: 748/808 (93%) subjects with severe asthma had one or more condition linked to systemic corticosteroid exposure (mild/moderate asthma 3109/3975 (78%), non-asthma controls 1548/2412 (64%); p<0.001 for severe asthma versus non-asthma controls). Compared with mild/moderate asthma, morbidity rates for severe asthma were significantly higher for conditions associated with systemic steroid exposure (type II diabetes 10% vs 7%, OR=1.46 (95% CI 1.11 to 1.91), p<0.01; osteoporosis 16% vs 4%, OR=5.23, (95% CI 3.97 to 6.89), p<0.001; dyspeptic disorders (including gastric/duodenal ulceration) 65% vs 34%, OR=3.99, (95% CI 3.37 to 4.72), p<0.001; cataracts 9% vs 5%, OR=1.89, (95% CI 1.39 to 2.56), p<0.001). In the British Thoracic Society Difficult Asthma Registry similar prevalence rates were found, although, additionally, high rates of osteopenia (35%) and obstructive sleep apnoea (11%) were identified.

Conclusions: Oral corticosteroid-related adverse events are common in severe asthma. New treatments which reduce exposure to oral corticosteroids may reduce the prevalence of these conditions and this should be considered in cost-effectiveness analyses of these new treatments.

Citing Articles

Natural killer cells in the lung: novel insight and future challenge in the airway diseases.

Pianigiani T, Paggi I, Cooper G, Staples K, McDonnell M, Bergantini L ERJ Open Res. 2025; 11(2).

PMID: 40071269 PMC: 11895099. DOI: 10.1183/23120541.00683-2024.


Health system characteristics and evidence-based asthma care.

Crawford A, Jones G, Scullion J, Ryan D, Blakey J Front Allergy. 2025; 6:1528526.

PMID: 40065833 PMC: 11891166. DOI: 10.3389/falgy.2025.1528526.


Diabetes-inducing effects of bronchial asthma.

Al-Beltagi M, Bediwy A, Saeed N, Bediwy H, Elbeltagi R World J Diabetes. 2025; 16(1):97954.

PMID: 39817208 PMC: 11718464. DOI: 10.4239/wjd.v16.i1.97954.


Costs of Oral Corticosteroid Use in Patients with Severe Asthma With/Without Chronic Rhinosinusitis with Nasal Polyps: Data from the Italian SANI Registry.

Heffler E, Blasi F, Paggiaro P, Canonica G Adv Ther. 2025; 42(2):1196-1206.

PMID: 39754702 PMC: 11787275. DOI: 10.1007/s12325-024-03071-w.


Maintenance oral steroids are not required in severe asthma.

Graham E, Eames C, Soe W, Fox L, Whitfield C, Kerley S ERJ Open Res. 2024; 10(6).

PMID: 39687394 PMC: 11647928. DOI: 10.1183/23120541.00568-2024.