Systematic Literature Review of Systemic Corticosteroid Use for Asthma Management

Eugene R Bleecker, Andrew N Menzies-Gow, David B Price, Arnaud Bourdin, Stephen Sweet, Amber L Martin, Marianna Alacqua, Trung N Tran

Research output: Contribution to journalArticle

14 Citations (Scopus)
3 Downloads (Pure)

Abstract

Systemic corticosteroid use to manage uncontrolled asthma and its associated health care burden may account for important health-related adverse effects. We conducted a systematic literature review to investigate the real-world extent and burden of systemic corticosteroid use in asthma. We searched MEDLINE® and Embase® databases to identify English-language articles published from 2010-2017, using search terms for asthma with key words for oral corticosteroids and systemic corticosteroids. Observational studies, prescription database analyses, economic analyses, and surveys on oral/systemic corticosteroid use for children (aged >5 years), adolescents (aged 12-17 years), and adults with asthma were included. We identified and reviewed 387 full-text articles, and our review included data from 139 studies. The included studies were conducted in Europe, North America, and Asia. Overall, oral/systemic corticosteroid use was common in asthma management and more frequent for patients with severe asthma compared with patients with milder disease. Long-term oral/systemic corticosteroid use was, in general, less frequent than short-term use. Compared with no use, long-term and repeated short-term oral/systemic corticosteroid use were associated with increased risk of acute and chronic adverse events (AEs), even when doses were comparatively low. Greater oral/systemic corticosteroid exposure was also associated with increased costs and health care resource utilization. This review provides a comprehensive overview of oral/systemic corticosteroid use and associated AEs for patients with all degrees of asthma severity and exposure duration. We report that oral/systemic corticosteroid use is prevalent in asthma management, and risks of acute and chronic complications increase with cumulative OCS dosage.

Original languageEnglish
Pages (from-to)276-293
Number of pages19
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume201
Issue number3
Early online date16 Sep 2019
DOIs
Publication statusPublished - 1 Feb 2020

Keywords

  • Asthma
  • Oral Corticosteroids
  • Severe Asthma
  • Systematic Literature Review
  • Systematic Corticosteroids
  • Systemic corticosteroids
  • Oral corticosteroids
  • Severe asthma
  • Systematic literature review
  • EMERGENCY-DEPARTMENT VISITS
  • INHALED CORTICOSTEROIDS
  • SEVERE ALLERGIC-ASTHMA
  • asthma
  • FLUTICASONE PROPIONATE/SALMETEROL
  • oral corticosteroids
  • TO-TREAT ASTHMA
  • ADD-ON THERAPY
  • PRESCRIPTION PATTERNS
  • ORAL CORTICOSTEROIDS
  • severe asthma
  • ACTING BETA-AGONISTS
  • HEALTH-CARE UTILIZATION
  • systematic literature review
  • systemic corticosteroids

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