Long-Term Use of Maintenance Systemic Corticosteroids is Associated with Multiple Adverse Conditions in a Large, Real-World Cohort of US Adults with Severe Asthma
Njira Lugogo,1 Bradley E Chipps,2 Reynold A Panettieri Jr,3 Frank Trudo,4 Christopher S Ambrose5 1University of Michigan, Ann Arbor, MI, USA; 2Capital Allergy & Respiratory Disease Center, Sacramento, CA, USA; 3Rutgers, The State University of New Jersey, New Brunswick, NJ, USA; 4AstraZeneca, Wi...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2022-12-01
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| Series: | Journal of Asthma and Allergy |
| Subjects: | |
| Online Access: | https://www.dovepress.com/long-term-use-of-maintenance-systemic-corticosteroids-is-associated-wi-peer-reviewed-fulltext-article-JAA |
| _version_ | 1797980651032412160 |
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| author | Lugogo N Chipps BE Panettieri RA Jr Trudo F Ambrose CS |
| author_facet | Lugogo N Chipps BE Panettieri RA Jr Trudo F Ambrose CS |
| author_sort | Lugogo N |
| collection | DOAJ |
| description | Njira Lugogo,1 Bradley E Chipps,2 Reynold A Panettieri Jr,3 Frank Trudo,4 Christopher S Ambrose5 1University of Michigan, Ann Arbor, MI, USA; 2Capital Allergy & Respiratory Disease Center, Sacramento, CA, USA; 3Rutgers, The State University of New Jersey, New Brunswick, NJ, USA; 4AstraZeneca, Wilmington, DE, USA; 5AstraZeneca, Gaithersburg, MD, USACorrespondence: Christopher S Ambrose, BioPharmaceuticals Medical, AstraZeneca, One MedImmune Way, Gaithersburg, MD, 20878, USA, Tel +1 301-398-4454, Email chris.ambrose@astrazeneca.comAbstract: There is growing recognition of the adverse consequences of maintenance systemic corticosteroid (mSCS) therapy in severe asthma (SA). The objective of this study was to describe the prevalence of potential adverse effects of long-term mSCS therapy in adults with specialist-confirmed SA in the United States (US). CHRONICLE is an ongoing, noninterventional, observational study of US adults with SA treated by allergists/immunologists and pulmonologists. Once enrolled, patients’ duration of mSCS therapy was reported by sites based on medical record review. For patients enrolled between February 2018 and February 2021, the prevalence of SCS-associated conditions was evaluated among those with no reported history of mSCS use, or mSCS use with < 2 years or ≥ 2 years cumulative duration. Prevalence and incidence estimates were adjusted for age and smoking history. Of 2793 patients enrolled, 311 and 231 had mSCS use for < 2 and ≥ 2 years, respectively. In adjusted analyses, adrenal insufficiency, pneumonia, type 2 diabetes, osteoporosis/osteopenia, congestive heart failure, coronary artery disease, hypertension, anxiety, and depression were statistically significantly associated with any mSCS use. By duration, mSCS use ≥ 2 years was associated with osteopenia/osteoporosis, coronary artery disease, adrenal insufficiency, and diabetes-related neuropathy; mSCS use < 2 years was associated with depression and osteopenia/osteoporosis, and diagnoses of depression, anxiety, and hypertension during the 12 months prior to enrollment. Overall, among patients with specialist-confirmed SA, mSCS use was associated with a high prevalence of multiple adverse conditions. Healthcare professionals should employ mSCS-sparing treatment strategies to avoid these negative consequences.Keywords: duration, steroids, diabetes, pneumonia, osteoporosis |
| first_indexed | 2024-04-11T05:58:14Z |
| format | Article |
| id | doaj.art-0c69998d17034f3385f181ae8ad12d73 |
| institution | Directory Open Access Journal |
| issn | 1178-6965 |
| language | English |
| last_indexed | 2024-04-11T05:58:14Z |
| publishDate | 2022-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Asthma and Allergy |
| spelling | doaj.art-0c69998d17034f3385f181ae8ad12d732022-12-22T04:41:49ZengDove Medical PressJournal of Asthma and Allergy1178-69652022-12-01Volume 151753176180175Long-Term Use of Maintenance Systemic Corticosteroids is Associated with Multiple Adverse Conditions in a Large, Real-World Cohort of US Adults with Severe AsthmaLugogo NChipps BEPanettieri RA JrTrudo FAmbrose CSNjira Lugogo,1 Bradley E Chipps,2 Reynold A Panettieri Jr,3 Frank Trudo,4 Christopher S Ambrose5 1University of Michigan, Ann Arbor, MI, USA; 2Capital Allergy & Respiratory Disease Center, Sacramento, CA, USA; 3Rutgers, The State University of New Jersey, New Brunswick, NJ, USA; 4AstraZeneca, Wilmington, DE, USA; 5AstraZeneca, Gaithersburg, MD, USACorrespondence: Christopher S Ambrose, BioPharmaceuticals Medical, AstraZeneca, One MedImmune Way, Gaithersburg, MD, 20878, USA, Tel +1 301-398-4454, Email chris.ambrose@astrazeneca.comAbstract: There is growing recognition of the adverse consequences of maintenance systemic corticosteroid (mSCS) therapy in severe asthma (SA). The objective of this study was to describe the prevalence of potential adverse effects of long-term mSCS therapy in adults with specialist-confirmed SA in the United States (US). CHRONICLE is an ongoing, noninterventional, observational study of US adults with SA treated by allergists/immunologists and pulmonologists. Once enrolled, patients’ duration of mSCS therapy was reported by sites based on medical record review. For patients enrolled between February 2018 and February 2021, the prevalence of SCS-associated conditions was evaluated among those with no reported history of mSCS use, or mSCS use with < 2 years or ≥ 2 years cumulative duration. Prevalence and incidence estimates were adjusted for age and smoking history. Of 2793 patients enrolled, 311 and 231 had mSCS use for < 2 and ≥ 2 years, respectively. In adjusted analyses, adrenal insufficiency, pneumonia, type 2 diabetes, osteoporosis/osteopenia, congestive heart failure, coronary artery disease, hypertension, anxiety, and depression were statistically significantly associated with any mSCS use. By duration, mSCS use ≥ 2 years was associated with osteopenia/osteoporosis, coronary artery disease, adrenal insufficiency, and diabetes-related neuropathy; mSCS use < 2 years was associated with depression and osteopenia/osteoporosis, and diagnoses of depression, anxiety, and hypertension during the 12 months prior to enrollment. Overall, among patients with specialist-confirmed SA, mSCS use was associated with a high prevalence of multiple adverse conditions. Healthcare professionals should employ mSCS-sparing treatment strategies to avoid these negative consequences.Keywords: duration, steroids, diabetes, pneumonia, osteoporosishttps://www.dovepress.com/long-term-use-of-maintenance-systemic-corticosteroids-is-associated-wi-peer-reviewed-fulltext-article-JAAdurationsteroidsdiabetespneumoniaosteoporosis |
| spellingShingle | Lugogo N Chipps BE Panettieri RA Jr Trudo F Ambrose CS Long-Term Use of Maintenance Systemic Corticosteroids is Associated with Multiple Adverse Conditions in a Large, Real-World Cohort of US Adults with Severe Asthma Journal of Asthma and Allergy duration steroids diabetes pneumonia osteoporosis |
| title | Long-Term Use of Maintenance Systemic Corticosteroids is Associated with Multiple Adverse Conditions in a Large, Real-World Cohort of US Adults with Severe Asthma |
| title_full | Long-Term Use of Maintenance Systemic Corticosteroids is Associated with Multiple Adverse Conditions in a Large, Real-World Cohort of US Adults with Severe Asthma |
| title_fullStr | Long-Term Use of Maintenance Systemic Corticosteroids is Associated with Multiple Adverse Conditions in a Large, Real-World Cohort of US Adults with Severe Asthma |
| title_full_unstemmed | Long-Term Use of Maintenance Systemic Corticosteroids is Associated with Multiple Adverse Conditions in a Large, Real-World Cohort of US Adults with Severe Asthma |
| title_short | Long-Term Use of Maintenance Systemic Corticosteroids is Associated with Multiple Adverse Conditions in a Large, Real-World Cohort of US Adults with Severe Asthma |
| title_sort | long term use of maintenance systemic corticosteroids is associated with multiple adverse conditions in a large real world cohort of us adults with severe asthma |
| topic | duration steroids diabetes pneumonia osteoporosis |
| url | https://www.dovepress.com/long-term-use-of-maintenance-systemic-corticosteroids-is-associated-wi-peer-reviewed-fulltext-article-JAA |
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