Oral corticosteroids (OCSs), especially at higher doses, are associated with a higher risk of complications and adverse events (AEs) in patients with asthma, according to the results of a systematic review.
The study authors aimed to assess AE risk and complications of OCS use in patients with asthma since most studies only report them in non-asthmatic patients. They reviewed MEDLINE (1946–May 2017), EMBASE (1974–May 2017), as well as the Cochrane Library (2005–May 2017) to obtain studies that analyzed AEs associated with OCS treatment in asthmatic adults, as well as its burden on healthcare utilization and cost.
A total of 15 studies were included in the review. “AEs were significantly higher among OCS-users compared with non-OCS users with pooled adjusted odds ratio (OR) 1.68 (95% CI 1.15–2.46) for diabetes mellitus and 1.34 (95% CI 1.23–1.46) for hypertension,” the study authors reported.
Results of the study also found that patients taking high doses of OCS (>10mg) had an increased risk of developing any complication (pooled adjusted OR: 3.35; 95% CI: 2.94, 3.82) and bone/muscle complications (pooled adjusted OR: 2.30; 95% CI: 2.18, 2.42) compared to non-OCS users.
“The risk of any complication increased with higher doses of OCS, with pooled adjusted OR from 2 studies of 2.26 (95% CI 1.37–3.72), 2.94 (95% CI 2.62–3.29) and 3.35 (95% CI 2.94–3.82) for low dose (<6mg), medium dose (5–12mg) and high dose (>10mg) respectively compared with no OCS use,” the study authors stated.
According to the results of this systematic review, a higher risk of complications was observed in patients taking OCS for the management of their asthma, especially in patients taking higher doses.
Efraij, KA et al. A systematic review of the adverse events and economic impact associated with oral corticosteroids in asthma. Journal of Asthma. https://doi.org/10.1080/02770903.2018.1539100