Aims: We investigated the prevalence of severe asthma, its comorbidities, and especially the use of oral corticosteroid (OCS) therapy in patients with severe asthma.
Methods: Pooled data from 3 961 429 patients insured (with statutory health insurance) during the year 2015 were analysed. Prevalence rates of severe asthma and its OCS-associated comorbidities in patients on high-dosage (HD) inhaled corticosteroid (ICS) in combination with a long-acting β agonist (LABA) therapy were compared with those of patients who were also treated with OCSs.
Results: The asthma prevalence was 7.3%, of which 8.7% (0.6% absolute) were treated with HD-ICS/LABAs. Of these, 33.6% received additional OCSs with calculated dosages between 0.9 and 9.1 mg·day. More than 80% of patients on HD-ICS/LABAs had at least one comorbidity. Disorders of the heart (67.5%), metabolism/ nutrition (51.4%), psychiatric disorders (36.0%), skeletal muscle/connective tissue and bone disorders (20.3%), and eye disorders (20.0%) were predominant. The prevalence of these disorders increased for patients also receiving OCS therapy, depending on the length of treatment. Mean therapy costs ranged from €4266 per patient without OCS therapy to €11 253 per patient on long-term OCS treatment. The largest share of costs was attributable to inpatient care.
Conclusion: The analyses show that OCSs are frequently prescribed in patients receiving HD-ICS/LABAs because of severe asthma and are they are frequently associated with adverse effects commonly reported with steroid usage. These data support a necessary change in severe asthma treatment, which is reflected in current treatment guidelines.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6819991 | PMC |
| http://dx.doi.org/10.1183/23120541.00092-2019 | DOI Listing |
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