Burden of chronic oral corticosteroids among adults with asthma in the United States

Background: Up to 60% of patients with severe asthma are prescribed oral corticosteroids (OCS) despite their adverse effects, increased risks of long-term complications, and development of comorbid conditions. Objective: We aimed to assess the clinical and economic burden of chronic OCS receipt in treating asthma. Methods: (≥2 bursts taken over 12 months). Patient demographics, OCS-related and other comorbidities, treatment patterns, health care resource utilization (HRU), and costs were described before and after patients met the definition of chronic OCS receipt. Results: The OCS continuous (≥10 mg/d), cumulative (≥500 mg), and burst (≥2 bursts) groups included 1358, 43,215, and 46,774 patients, respectively. Before OCS receipt, continuous recipients were older and had higher comorbidity burden than cumulative and burst recipients. After OCS receipt, continuous recipients had higher OCS exposure, higher OCS comorbidity rates, higher asthma-related HRU, and higher asthma-related health care costs than cumulative and burst recipients. Respiratory medication receipt and asthma exacerbation rates were similar across groups, both at baseline and after identification of chronic OCS receipt. Conclusion: Our findings highlight increased OCS-related comorbidity, HRU, and economic burden after chronic OCS receipt among US patients with asthma.