Systematic Literature Review of Systemic Corticosteroid Use for Asthma Management

Eugene R Bleecker, Andrew N Menzies-Gow, David B Price, Arnaud Bourdin, Stephen Sweet, Amber L Martin, Marianna Alacqua, Trung N Tran

Research output: Contribution to journalArticlepeer-review

166 Citations (Scopus)
6 Downloads (Pure)

Abstract

Systemic corticosteroid use to manage uncontrolled asthma and its associated health care burden may account for important health-related adverse effects. We conducted a systematic literature review to investigate the real-world extent and burden of systemic corticosteroid use in asthma. We searched MEDLINE® and Embase® databases to identify English-language articles published from 2010-2017, using search terms for asthma with key words for oral corticosteroids and systemic corticosteroids. Observational studies, prescription database analyses, economic analyses, and surveys on oral/systemic corticosteroid use for children (aged >5 years), adolescents (aged 12-17 years), and adults with asthma were included. We identified and reviewed 387 full-text articles, and our review included data from 139 studies. The included studies were conducted in Europe, North America, and Asia. Overall, oral/systemic corticosteroid use was common in asthma management and more frequent for patients with severe asthma compared with patients with milder disease. Long-term oral/systemic corticosteroid use was, in general, less frequent than short-term use. Compared with no use, long-term and repeated short-term oral/systemic corticosteroid use were associated with increased risk of acute and chronic adverse events (AEs), even when doses were comparatively low. Greater oral/systemic corticosteroid exposure was also associated with increased costs and health care resource utilization. This review provides a comprehensive overview of oral/systemic corticosteroid use and associated AEs for patients with all degrees of asthma severity and exposure duration. We report that oral/systemic corticosteroid use is prevalent in asthma management, and risks of acute and chronic complications increase with cumulative OCS dosage.

Original languageEnglish
Pages (from-to)276-293
Number of pages19
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume201
Issue number3
Early online date16 Sept 2019
DOIs
Publication statusPublished - 1 Feb 2020

Bibliographical note

Writing and editing assistance, including preparation of a draft manuscript under the direction and guidance of the authors, incorporating author feedback, and manuscript submission, was provided by Debra Scates, Ph.D., of JK Associates, Inc., and Michael A. Nissen, E.L.S., of AstraZeneca. This support was funded by AstraZeneca.

Keywords

  • Asthma
  • Oral Corticosteroids
  • Severe Asthma
  • Systematic Literature Review
  • Systematic Corticosteroids
  • Systemic corticosteroids
  • Oral corticosteroids
  • Severe asthma
  • Systematic literature review
  • EMERGENCY-DEPARTMENT VISITS
  • INHALED CORTICOSTEROIDS
  • SEVERE ALLERGIC-ASTHMA
  • asthma
  • FLUTICASONE PROPIONATE/SALMETEROL
  • oral corticosteroids
  • TO-TREAT ASTHMA
  • ADD-ON THERAPY
  • PRESCRIPTION PATTERNS
  • ORAL CORTICOSTEROIDS
  • severe asthma
  • ACTING BETA-AGONISTS
  • HEALTH-CARE UTILIZATION
  • systematic literature review
  • systemic corticosteroids

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