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Systemic corticosteroid use increased the risk for adverse events, healthcare resource utilization, and costs for American patients with asthma.

Systemic corticosteroid (SCS) use increased the risk of adverse events, healthcare resource utilization (HCRU), and costs in US patients with asthma, according to a retrospective cohort study published in the Journal of Medical Economics.

“The study showed that patients who received SCS were at a significantly increased risk of medication-related adverse events, both in terms of acute and chronic clinical complications,” wrote corresponding author Michelle Vu, PharmD, and colleagues. “These complications affect a range of systems, including diseases associated with the heart, kidneys, eyes, skin, and brain.”

The study analyzed insurance claims in the Optum Research Database for 130,739 patients with asthma. Among them, 75,376 were SCS users. Researchers investigated SCS-related adverse events over 48 months after a patient’s first SCS claim. HCRU and costs were also assessed over the first 12 months of SCS use. Researchers compared the findings with those for 55,363 randomly selected non-SCS users.

Patients in the analysis had a mean age of 49.6 years. Among patients who used SCS, 60,319 were categorized as low-dose users (1-499 mg of prednisone equivalents over 12 months), 12,235 as medium-dose users (500-1,000 mg of prednisone equivalents), and 2,822 as high-dose users (>1,000 mg of prednisone equivalents).

Patients who used SCS were at significantly higher risk for new-onset acute and chronic adverse events, which increased with SCS dose exposure, according to the study. Over the first 12 months of follow-up alone, new-onset acute or chronic SCS-related adverse events affected 68.4% of low-dose SCS users, 74.8% of medium-dose SCS users, and 76.5% of high-dose SCS users, compared with 46.9% of non-SCS users.

HCRU and costs over follow-up also increased incrementally with SCS dose. Compared with patients who did not use SCS, SCS-related costs were 1.43 times higher for low-dose SCS users, 1.97 times higher for medium-dose SCS users, and 3.21 times higher for high-dose SCS users. Adjusted analysis identified a 9.9% increase in costs for every 100 mg of prednisone equivalents.

“While we observed significant increases in SCS-related AEs [adverse events] during the first 12 months of follow-up alone, risk continued to increase with longer follow-up durations,” researchers wrote. “These findings highlight the clinical and health economic consequences of SCS use in asthma management and underscore the importance of minimizing SCS exposure whenever feasible.”