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.

Joan Sweeney, Chris C Patterson, Andrew Menzies-Gow, Rob M Niven, Adel H Mansur, Christine Bucknall, Rekha Chaudhuri, David Price, Christ E Brightling, Liam G Heaney

OPCRD was used in the recently published paper in Thorax, the journal of the British Throracic Society (BTS). A link to the paper can be found below:

http://thorax.bmj.com/content/early/2016/01/27/thoraxjnl-2015-207630.abstract

The paper aims to determine the prevalence of systemic corticosteroid-induced morbidity in severe asthma. The Cross-sectional observational study utilized OPCRD and the BTS Difficult Asthma Registry, looking at 7,195 patients in three age and gender matched groups based on the severity of their asthma. The prevalence rate of morbidities associated with systemic steroid exposure were evaluated and reported separately for each group.

Results

  • 93% of patients with severe asthma had one or more condition linked to systemic corticosteroid exposure
  • 78% in mild/moderate asthma
  • 64% in non-asthma control
  • Of particular note Type II Diabetes, osteoporosis, dystpeptic disorders and cataracts showed notably higher rates within severe asthma patients.
  • This was corroborated by the Difficult Asthma Registry, which also noted high rates within osteopenia and obstructive sleep apnoea.

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
  • This should be considered in cost-effectiveness analyses of these new treatments