Oral corticosteroid (OCS) risk predictor for Type II Diabetes in asthma

Introduction: OCS use is associated with adverse outcomes, including type II diabetes (DM-T2). Individualized models to estimate risks from prior and future OCS use could facilitate clinical planning.Objective: Develop a model to estimate risk of DM-T2 in patients with asthma.Methods: A historical cohort study of adults with asthma at index date with ≥2 years of baseline (pre-index) and ≥3 years of follow-up data (post-index) from the Optimum Patient Care Research Database. Primary outcome was time to DM-T2 diagnosis in those with no prior DM-T2 history. Cox regression models were used to model known DM-T2 risk factors selected from literature and included based on backwards stepwise selection, including change in average annual OCS use over time (decreased, no change, increased, Figure). The model was evaluated in 75% of patients and validated in the remainder. Kaplan Meier curves were used to evaluate separation between stratified risk groups.Results: Overall, 104,461 patients met all inclusion criteria (7452 developed DM-T2). The model validation showed a consistently higher predicted DM-T2 risk among patients who increased their OCS use compared to baseline (HR for 1-step increase = 1.551). In an example patient, 20-year DM-T2 risks were 7.3%, 8.9%, and 13.4% for decreased, no change, and increased OCS usage, post-index date, respectively (Figure).Conclusion: Risk for DM-T2 can be moderated by lowering OCS usage in asthma patients.FootnotesCite this article as Eur Respir J 2022; 60: Suppl. 66, 4420.This article was presented at the 2022 ERS International Congress, in session “-”.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).