RT Journal Article
SR Electronic
T1 Late Breaking Abstract - Overuse of oral corticosteroids in asthma – modifiable factors and potential role of biologics
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA5334
DO 10.1183/13993003.congress-2019.OA5334
VO 54
IS suppl 63
A1 Katrien A.B. Eger
A1 Marijke Amelink
A1 Pieter Paul Hekking
A1 Elisabeth Bel
YR 2019
UL http://erj.ersjournals.com/content/54/suppl_63/OA5334.abstract
AB Background: Asthma patients using high doses of oral corticosteroids are exposed to serious adverse effects. It is therefore important to know the prevalence and characteristics of these patients, as this may help physicians to find appropriate measures and therapies to reduce the use of these harmful drugs.Aim: We assessed the prevalence of asthma patients using high-dose oral corticosteroids, to investigate whether this use was justified, and to estimate the proportion of patients eligible for steroid-sparing biologics.Methods: A pharmacy database containing data from 500,500 Dutch inhabitants was used to select patients using high dose inhaled corticosteroids (≥500 mcg/day) plus longacting β-agonists (GINA 4-5). 5002 of these patients were sent questionnaires, 2312 were returned and analyzed. In patients in whom asthma diagnosis was confirmed oral corticosteroid use was calculated, and adherence to treatment and inhaler technique were assessed. The proportions of cases from this analysis were applied to the Dutch population.Results: 29% of asthma patients using high-dose inhaled corticosteroids were exposed to harmful doses of oral corticosteroids (≥420 mg/yr). 78% of these patients showed either poor adherence to treatment or incorrect inhalation technique. The remaining patients could be candidates for biologics, but currently, in the Netherlands, only 46% are receiving these drugs.Conclusion: One third of GINA 4-5 patients use harmful doses of oral corticosteroids. In the majority a potential cause for overuse can be identified, and only a small proportion is receiving steroid-sparing biologics. Taking this into account, oral corticosteroid overuse could be substantially reduced.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, OA5334.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).