Asthma and lower airway diseaseAcute and chronic systemic corticosteroid–related complications in patients with severe asthma
Section snippets
Data source
This study used claims data from Medicaid health insurance beneficiaries from 6 US states: Florida (2001-2012), Iowa (1998-2013), Kansas (2001-2013), Missouri (1997-2013), Mississippi (2006-2013), and New Jersey (1997-2013). This data set was chosen because of the long enrollment duration of Medicaid recipients, which permitted observation of both short- and long-term SCS-related complications. Data elements used in the present analysis included information on enrollment history, patient
Baseline characteristics
A total of 3628 patients were included in the study (see Fig E2 in this article's Online Repository at www.jacionline.org). Table I presents their baseline characteristics grouped by SCS exposure at the index date (low, 368 [10.1%] patients; medium, 1630 [45.0%] patients; high, 1630 [45.0%] patients). Lower SCS exposure subgroups were older on average (low, 62.4 years; medium, 60.0 years; high, 54.2 years), included more female subjects (low, 70.7%; medium, 69.7%; high, 66.4%), and had a longer
Discussion
Because of established clinical efficacy, SCSs are widely used to treat numerous inflammatory diseases, including asthma. However, their chronic use can lead to troublesome and severe complications.8 This is the first longitudinal observational study evaluating the risk of SCS-related complications and their associated health care resource use and costs in a large US cohort of Medicaid beneficiaries with severe asthma and chronic SCS use.
Systematic literature reviews on SCS-related
References (30)
- et al.
Acute asthma in adults: a review
Chest
(2004) - et al.
Effect of asthma exacerbations on health care costs among asthmatic patients with moderate and severe persistent asthma
J Allergy Clin Immunol
(2012) - et al.
Incidence and US costs of corticosteroid-associated adverse events: a systematic literature review
Clin Ther
(2011) - et al.
A new method of classifying prognostic comorbidity in longitudinal studies: development and validation
J Chronic Dis
(1987) - et al.
The cumulative burden of oral corticosteroid side effects and the economic implications of steroid use
Respir Med
(2009) - et al.
Use of oral corticosteroids and the risk of acute myocardial infarction
Atherosclerosis
(2007) - et al.
Treatment patterns in the months prior to and after asthma-related emergency department visit*
Chest
(2004) Guidelines for the diagnosis and management of asthma
(2007)- et al.
Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma
N Engl J Med
(2014) - et al.
Optimal management of severe/refractory asthma
Clin Med Insights Circ Respir Pulm Med
(2011)
The ENFUMOSA cross-sectional European multicentre study of the clinical phenotype of chronic severe asthma. European Network for Understanding Mechanisms of Severe Asthma
Eur Respir J
Refractory asthma in the UK: cross-sectional findings from a UK multicentre registry
Thorax
Adverse drug events in U.S. hospitals, 2004
Healthcare Cost and Utilization Project. Statistical Brief #29.
Adverse events of low- to medium-dose oral glucocorticoids in inflammatory diseases: a meta-analysis
Ann Rheum Dis
Relationship between prednisone, lupus activity and permanent organ damage
J Rheumatol
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Supported by GlaxoSmithKline (study no. HO-13-12748). Editorial support was also funded by GlaxoSmithKline.
Disclosure of potential conflict of interest: P. Lefebvre and M.-N. Robitaille have received research support from GlaxoSmithKline. M. S. Duh has received research support from GlaxoSmithKline, Janssen, Novo Nordisk, Novartis, Ariad, Pfizer, Sanofi, and Bayer. M.-H. Lafeuille, L. Gozalo, and U. Desai are employed by Groupe d'analyse, a research company that has received research grants from GlaxoSmithKline. F. Albers, S. Yancey, H. Ortega, M. Forshag, X. Lin, and A. A. Dalal are employed by and have stock/stock options in GlaxoSmithKline.