Oral Corticosteroid Prescription Patterns for Asthma in France, Germany, Italy, and the United Kingdom
- Trung N. Tran1⇑,
- Elizabeth King2,
- Rajiv Sarkar3,
- Cassandra Nan4,
- Annalisa Rubino5,
- Caroline O'Leary2,
- Ruvimbo Muzwidzwa2,
- Laura Belton6 and
- Jennifer K. Quint7
- 1AstraZeneca, Gaithersburg, MD, USA
- 2IQVIA, London, United Kingdom
- 3IQVIA, Bengaluru, India
- 4AstraZeneca, Mölndal, Sweden
- 5Evidera, London, United Kingdom
- 6AstraZeneca, Cambridge, United Kingdom
- 7Imperial College London, London, United Kingdom
- Dr Trung N. Tran, MD, PhD, AstraZeneca, Gaithersburg, MD, USA. E-mail: trung.tran1{at}astrazeneca.com
Abstract
Oral corticosteroids (OCS) are used to manage asthma exacerbations and severe, uncontrolled asthma, but OCS use is associated with adverse effects. We aimed to describe the patterns of OCS use in the real-world management of patients with asthma in western Europe.
We used electronic medical records from databases in France, Germany, Italy, and the United Kingdom from July 2011 through February 2018. Patients aged ≥12 years with an asthma diagnosis, ≥1 non-OCS asthma medication within ±6 months of diagnosis, and available data ≥6 months prior to and ≥90 days after cohort entry were included. High OCS use was defined as OCS ≥450 mg prescribed in a 90-day window during follow-up. Baseline characteristics and OCS use during follow-up were described overall and by OCS use status.
Of 702 685 patients with asthma, 14–44% were OCS users and 6–9% were high OCS users at some point during follow-up. Annual prevalence of high OCS use across all countries was approximately 3%. High OCS users had a mean 1–3 annual OCS prescriptions, with an average daily OCS dosage of 1.3–2.2 mg. For patients who continued to meet the high use definition, daily OCS exposure was generally stable at 5.5–7.5 mg for at least 2 years, increasing the risk of adverse effects.
Our study demonstrates that OCS use is relatively common across the four studied European countries. Data from this study may provide decisive clinical insights to inform primary care physicians and specialists involved in the management of severe, uncontrolled asthma.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Tran reports personal fees from AstraZeneca, outside the submitted work.
Conflict of interest: Dr. King reports personal fees from IQVIA, outside the submitted work.
Conflict of interest: Dr. Sarkar reports personal fees from IQVIA, outside the submitted work.
Conflict of interest: Dr. Nan reports personal fees from AstraZeneca, personal fees from GlaxoSmithKline, outside the submitted work.
Conflict of interest: Dr. Rubino reports personal fees from Evidera, outside the submitted work.
Conflict of interest: Dr. O'Leary reports personal fees from IQVIA, outside the submitted work.
Conflict of interest: Dr. Muzwidzwa reports personal fees from IQVIA, outside the submitted work.
Conflict of interest: Dr. Belton reports personal fees from AstraZeneca, outside the submitted work.
Conflict of interest: Dr. Quint reports other from Imperial College London, outside the submitted work.
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- Received December 9, 2019.
- Accepted February 27, 2020.
- Copyright ©ERS 2020