The Risks of Intermittent Oral Corticosteroid Exposure

Intermittent exposure to oral corticosteroids (OCS) may raise the odds of an adverse effect in patients with severe asthma, according to a study published online in The Journal of Allergy and Clinical Immunology.

“While previous research has documented the deleterious effect of continuous OCS exposure in severe asthma, our results suggest that each OCS prescription may result in a cumulative burden on current and future health, regardless of dose and duration,” researchers wrote (doi:10.1016/j.jaci.2017.04.009). “OCS-sparing strategies are extremely important to improving patient outcomes.”

OCS use is widespread among patients with severe asthma, Monthly Prescribing Reference reported (May 1, 2017). For the study, researchers took a retrospective look at adverse events in 72,063 adults with severe asthma prescribed OCSs compared with 156,373 adults who did not take them. Data came from the 2000-2014 MarketScan database, and patient follow-up lasted 24 months to 10 years.

The odds of experiencing a new adverse event within a year were 1.29 times greater in patients who took 4 or more OCS prescriptions that year, researchers found. Every year of current and past exposure to 4 or more OCS prescriptions increased the odds of experiencing an adverse event that year by 1.20 times.

Patients who took 4 or more OCS prescriptions had significantly greater odds of the following adverse events: osteoporosis, hypertension, obesity, type 2 diabetes, gastrointestinal ulcers/bleeds, fractures, and cataracts. The odds ranged from 1.21-1.44, depending on the adverse event.

 —Jolynn Tumolo