Overuse of oral corticosteroids is common among Canadian patients with severe asthma

Oral corticosteroids (OCS) are literal lifesavers for severe asthma, but overuse is associated with an increased risk of adverse effects and increased healthcare use and costs. Findings from a new real-world evidence study, Characterizing Uncontrolled Severe Asthma in Canada (ALERT), provide new insights into the overuse of oral corticosteroids (OCS) among Canadians with uncontrolled severe asthma.The findings were presented at the American College of Chest Physicians Annual Meeting in Boston and the European Respiratory Society Congress in Vienna. The ALERT study was conducted by GlaxoSmithKline (GSK), a biopharma company, in collaboration with Asthma Canada, Dr. Susan Waserman of McMaster University in Hamilton, Ont. and Dr. Andréanne Côté of the Quebec Heart and Lung Institute and the Université Laval in Quebec City. It’s a research project to gain insights into managing uncontrolled severe asthma across Canada. Leveraging data from the IQVIA Private Drug Plan database, it analyzed prescription claim trends for OCS and biologics between April 2020 and June 2023. In this study, uncontrolled severe asthma is defined as cases requiring two or more OCS claims within one year, highlighting instances of poor control despite standard treatments.“In an era with so many available treatment options for asthma, it is appalling to witness such a high rate of OCS overuse," said Dr. Andréanne Côté in a GSK press release. "Better identification of uncontrolled patients and easier access to treatment optimization should be a top priority in the care of those patients.In the study, 7.5% of asthma patients were classified as having severe asthma and of those, 12.7% were classified as having uncontrolled severe asthma. Over 70% of patients with uncontrolled severe asthma were not on available biologic therapy and 40% of patients with uncontrolled severe asthma had had four or more OCS courses. The Global Initiative for Asthma (GINA) provides guidelines on asthma management, including the appropriate use of OCS and its tapering. It recommends that if a patient has more than two courses of OCS a year, they should see a specialist.Step in the right directionCommon OCS types include prednisone, methylprednisolone and hydrocortisone. Historically, daily OCS were crucial for managing severe or uncontrolled asthma, but with the development of biologic therapies, OCS are now primarily recommended for handling asthma attacks.While life-saving in severe exacerbations, OCS use in asthma is increasingly recognized as a cause of short- and long-term adverse effects. Frequent or prolonged OCS use can pose substantial health risks, which has resulted in OCS-sparing strategies in asthma care. Adverse effects from OCS include heightened infection and cardiovascular risks, osteoporosis, type 2 diabetes, weight gain, and mood or behavioural changes. According to Asthma Canada, the risk of adverse effects increases as OCS dosage, including cumulative dosage, increases. Strategies to minimize the need for their use are needed, the organization says.“Recognizing the alarming OCS overuse is a step in the right direction to raise awareness among practitioners and patients of alternative treatment options for asthma management," said Dr. Waserman, in the press release. "Further education could enhance the adoption of these treatments to optimize outcomes."

Overuse of oral corticosteroids is common among Canadian patients with severe asthma

Register for free access or login.

Related Topics