PMID- 30513226
OWN - NLM
STAT- MEDLINE
DCOM- 20200511
LR  - 20200511
IS  - 1532-4303 (Electronic)
IS  - 0277-0903 (Linking)
VI  - 56
IP  - 12
DP  - 2019 Dec
TI  - A systematic review of the adverse events and economic impact associated with 
      oral corticosteroids in asthma.
PG  - 1334-1346
LID - 10.1080/02770903.2018.1539100 [doi]
AB  - Background: Oral corticosteroids (OCSs) are often used to achieve asthma control. 
      OCS-related comorbidities increase the burden of disease for patients and 
      healthcare providers. Most studies characterizing OCS use and risk of adverse 
      events (AEs) are in non-asthma patients. We sought to systematically review the 
      literature on the burden of OCS use among adults with asthma. Methods: We 
      systematically reviewed the literature including MEDLINE (1946-May 2017), EMBASE 
      (1974-May 2017), and the Cochrane Library (2005-May 2017) to identify studies 
      that considered AEs due to OCS treatment of adults with asthma, their burden on 
      healthcare utilization, and costs. Results: We retrieved 9,589 citations; and 15 
      studies were included. 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. Among high 
      dose OCS-users (>10 mg) compared with non-OCS users, the pooled adjusted ORs for 
      development of any complication was 3.35 (95% CI 2.94-3.82), and bone and muscle 
      complications 2.30 (95% CI 2.18-2.42). 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 (<6 
      mg), medium dose (5-12 mg) and high dose (>10 mg) respectively compared with no 
      OCS use. Conclusions: The use of OCS in the management of asthma is associated 
      with a higher risk of complications. This risk is higher as the OCS dose 
      increases.
FAU - Al Efraij, Khalid
AU  - Al Efraij K
AD  - Faculty of Medicine, Division of Respiratory Medicine, UBC , Vancouver , Canada.
FAU - Johnson, Kate M
AU  - Johnson KM
AD  - Faculty of Pharmaceutical Sciences, UBC , Vancouver , Canada.
FAU - Wiebe, Darrin
AU  - Wiebe D
AD  - Department of Internal Medicine, UBC , Vancouver , Canada.
FAU - Sadatsafavi, Mohsen
AU  - Sadatsafavi M
AD  - Faculty of Pharmaceutical Sciences, UBC , Vancouver , Canada.
FAU - FitzGerald, J Mark
AU  - FitzGerald JM
AD  - Faculty of Medicine, Division of Respiratory Medicine, UBC , Vancouver , Canada.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20181204
PL  - England
TA  - J Asthma
JT  - The Journal of asthma : official journal of the Association for the Care of 
      Asthma
JID - 8106454
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-Asthmatic Agents)
SB  - IM
MH  - Administration, Oral
MH  - Adrenal Cortex Hormones/administration & dosage/*adverse effects/economics
MH  - Adult
MH  - Anti-Asthmatic Agents/administration & dosage/*adverse effects
MH  - Asthma/diagnosis/*drug therapy/economics
MH  - Cost of Illness
MH  - Drug-Related Side Effects and Adverse Reactions/*economics/etiology
MH  - Female
MH  - Health Personnel/organization & administration
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Patient Acceptance of Health Care/*statistics & numerical data
MH  - Risk Assessment
MH  - Socioeconomic Factors
MH  - United States
OTO - NOTNLM
OT  - Asthma
OT  - adverse events
OT  - morbidity; burden; economy
OT  - oral corticosteroids
EDAT- 2018/12/05 06:00
MHDA- 2020/05/12 06:00
CRDT- 2018/12/05 06:00
PHST- 2018/12/05 06:00 [pubmed]
PHST- 2020/05/12 06:00 [medline]
PHST- 2018/12/05 06:00 [entrez]
AID - 10.1080/02770903.2018.1539100 [doi]
PST - ppublish
SO  - J Asthma. 2019 Dec;56(12):1334-1346. doi: 10.1080/02770903.2018.1539100. Epub 
      2018 Dec 4.