Longitudinal patterns of intermittent oral corticosteroid therapy for asthma in the United Kingdom
© 2024 AstraZeneca Pharmaceuticals LP..
Background: Increasing frequency of intermittent oral corticosteroid (OCS) prescription and cumulative OCS exposure increase the risk of OCS-related adverse outcomes.
Objective: We sought to describe the evolution and trajectory of intermittent OCS prescription patterns in patients with asthma and investigate risk factors independently associated with transitioning to a frequent prescription pattern.
Methods: This historical cohort study included patients with active asthma managed in UK primary care and included in the Optimum Patient Care Research Database (OPCRD; opcrd.co.uk). Intermittent OCS prescription patterns were categorized as sporadic, infrequent, moderately frequent, or frequent. Prescription pattern sequences were described for those who had a frequent sequence in their final year of prescribing. We examined associations between OCS prescription pattern and the hazard of transitioning into a frequent intermittent OCS prescription pattern using multivariable Cox regression with a 10-year look-back period.
Results: Of 105,229 patients with intermittent OCS prescriptions, 57.1% (n = 60,083) had a frequent OCS prescription pattern at some point. Irrespective of baseline pattern, most patients transitioned to frequent prescription during the look back. The strongest risk factors were a more frequent prescription pattern at the start of look-back period, a lower percentage peak expiratory flow rate, and higher Global Initiative for Asthma treatment step. Older age, female sex, obesity, and active smoking were also associated with a higher risk of transitioning.
Conclusion: Our findings help identify those most at risk of transitioning to frequent intermittent OCS receipt and encourage earlier intervention with OCS-sparing treatments.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:3 |
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| Enthalten in: |
The journal of allergy and clinical immunology. Global - 3(2024), 2 vom: 30. März, Seite 100225 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tran, Trung N [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 26.03.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.jacig.2024.100225 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370143639 |
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| 520 | |a Background: Increasing frequency of intermittent oral corticosteroid (OCS) prescription and cumulative OCS exposure increase the risk of OCS-related adverse outcomes | ||
| 520 | |a Objective: We sought to describe the evolution and trajectory of intermittent OCS prescription patterns in patients with asthma and investigate risk factors independently associated with transitioning to a frequent prescription pattern | ||
| 520 | |a Methods: This historical cohort study included patients with active asthma managed in UK primary care and included in the Optimum Patient Care Research Database (OPCRD; opcrd.co.uk). Intermittent OCS prescription patterns were categorized as sporadic, infrequent, moderately frequent, or frequent. Prescription pattern sequences were described for those who had a frequent sequence in their final year of prescribing. We examined associations between OCS prescription pattern and the hazard of transitioning into a frequent intermittent OCS prescription pattern using multivariable Cox regression with a 10-year look-back period | ||
| 520 | |a Results: Of 105,229 patients with intermittent OCS prescriptions, 57.1% (n = 60,083) had a frequent OCS prescription pattern at some point. Irrespective of baseline pattern, most patients transitioned to frequent prescription during the look back. The strongest risk factors were a more frequent prescription pattern at the start of look-back period, a lower percentage peak expiratory flow rate, and higher Global Initiative for Asthma treatment step. Older age, female sex, obesity, and active smoking were also associated with a higher risk of transitioning | ||
| 520 | |a Conclusion: Our findings help identify those most at risk of transitioning to frequent intermittent OCS receipt and encourage earlier intervention with OCS-sparing treatments | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a OCS | |
| 650 | 4 | |a asthma | |
| 650 | 4 | |a intermittent | |
| 650 | 4 | |a prescription | |
| 650 | 4 | |a risk | |
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| 700 | 1 | |a Rowell, Jennifer |e verfasserin |4 aut | |
| 700 | 1 | |a Chan, Jeffrey Shi Kai |e verfasserin |4 aut | |
| 700 | 1 | |a Bourdin, Arnaud |e verfasserin |4 aut | |
| 700 | 1 | |a Chapaneri, Jatin |e verfasserin |4 aut | |
| 700 | 1 | |a Emmanuel, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Gibson, Danny |e verfasserin |4 aut | |
| 700 | 1 | |a Jackson, David J |e verfasserin |4 aut | |
| 700 | 1 | |a Menzies-Gow, Andrew N |e verfasserin |4 aut | |
| 700 | 1 | |a Murray, Ruth |e verfasserin |4 aut | |
| 700 | 1 | |a Skinner, Derek |e verfasserin |4 aut | |
| 700 | 1 | |a Price, David B |e verfasserin |4 aut | |
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