TY - JOUR
T1 - Systematic literature review of systemic corticosteroid use for asthma management
AU - Bleecker, Eugene R.
AU - Menzies-Gow, Andrew N.
AU - Price, David B.
AU - Bourdin, Arnaud
AU - Sweet, Stephen
AU - Martin, Amber L.
AU - Alacqua, Marianna
AU - Tran, Trung N.
N1 - Funding Information:
(Received in original form April 29, 2019; accepted in final form September 16, 2019) This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/). For commercial usage and reprints, please contact Diane Gern (dgern@thoracic.org). Supported by AstraZeneca. The funder of the study collaborated in the study design, data collection, data analysis, data interpretation, and writing of the report. Author Contributions: S.S., A.L.M., M.A., and T.N.T. conceived, designed, and executed the literature search. All authors had access to and analyzed and interpreted the data. All authors participated in the development and critical review of the manuscript. E.R.B. had full access to all of the data in the study and had final responsibility for the decision to submit for publication. All authors provided final approval for publication submission and are accountable for the accuracy and integrity of the work.
Funding Information:
Associates, Inc., and Michael A. Nissen, E.L.S., of AstraZeneca. This support was funded by AstraZeneca.
Publisher Copyright:
Copyright © 2020 by the American Thoracic Society.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Systemic corticosteroid use to manage uncontrolled asthma and its associated healthcare burden may account for important healthrelated 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 in 2010-2017, using search terms for asthma with keywords for oral corticosteroids and systemic corticosteroids. Observational studies, prescription database analyses, economic analyses, and surveys on oral/systemic corticosteroid use in children (>5 yr old), adolescents (12-17 yr old), 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 corticosteroids were commonly used for asthma management and were more frequently used in patients with severe asthma than in those 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 an increased risk of acute and chronic adverse events, even when doses were comparatively low. Greater oral/systemic corticosteroid exposure was also associated with increased costs and healthcare resource use. This review provides a comprehensive overview of oral/systemic corticosteroid use and associated adverse events for patients with all degrees of asthma severity and exposure duration. We report that oral/systemic corticosteroid use is prevalent in asthma management, and the risks of acute and chronic complications increase with the cumulative oral corticosteroid dosage.
AB - Systemic corticosteroid use to manage uncontrolled asthma and its associated healthcare burden may account for important healthrelated 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 in 2010-2017, using search terms for asthma with keywords for oral corticosteroids and systemic corticosteroids. Observational studies, prescription database analyses, economic analyses, and surveys on oral/systemic corticosteroid use in children (>5 yr old), adolescents (12-17 yr old), 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 corticosteroids were commonly used for asthma management and were more frequently used in patients with severe asthma than in those 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 an increased risk of acute and chronic adverse events, even when doses were comparatively low. Greater oral/systemic corticosteroid exposure was also associated with increased costs and healthcare resource use. This review provides a comprehensive overview of oral/systemic corticosteroid use and associated adverse events for patients with all degrees of asthma severity and exposure duration. We report that oral/systemic corticosteroid use is prevalent in asthma management, and the risks of acute and chronic complications increase with the cumulative oral corticosteroid dosage.
KW - Asthma
KW - Oral corticosteroids
KW - Severe asthma
KW - Systematic literature review
KW - Systemic corticosteroids
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U2 - 10.1164/rccm.201904-0903SO
DO - 10.1164/rccm.201904-0903SO
M3 - Review article
C2 - 31525297
AN - SCOPUS:85078634867
SN - 1073-449X
VL - 201
SP - 276
EP - 293
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
IS - 3
ER -