Oral corticosteroid prescription patterns in asthma care in Italy

Abstract

Background: Oral corticosteroids (OCS) are often prescribed for treatment of asthma exacerbations, or as part of daily maintenance therapy for patients with severe asthma, although they are associated with adverse effects Aims and Objectives: To describe the patterns of OCS use and characteristics of patients with asthma by OCS use status in Italy. Methods: Electronic medical records from the Longitudinal Patient Database for general practice in Italy from 1/7/11–31/12/17 were used. Included patients were ≥12 years old with ≥1 asthma diagnosis and had data available for ≥183 days before and ≥90 days after cohort entry. Long-term (LT) use was defined as ≥450 mg OCS prescribed in a 90-day period during follow up. Patients were classified by their OCS use: non-user or OCS user (including non-LT and LT). Baseline characteristics and OCS prescription patterns during follow up were described overall and by OCS use. Results: Among the 97,187 study patients, 42.6% were OCS users and 8.7% were LT OCS users at some point during follow up. One-year prevalence of LT OCS use from cohort entry was 3.7%. OCS users, especially LT OCS users, were older, were more likely to be female, be obese, have severe asthma, and have more comorbidities, and were less likely to be active smokers than non-OCS users. The mean annual number of OCS prescriptions was 1.7 for LT users and 0.6 for non-LT users. Mean daily OCS dosage was 1.4 mg for LT users and 0.3 mg for non-LT users. Conclusion: OCS use is relatively common in asthma treatment in Italy, suggesting suboptimal asthma management. OCS therapy should be considered carefully to avoid associated adverse effects.