Patient-reported side effects of oral corticosteroids

Abstract

The toxic side effects of oral corticosteroids (OCS) have long been recognised. The need to show effectiveness of new, expensive, potentially steroid-sparing biological therapies for severe asthma requires objective measurement of steroid-induced complications. Existing questionnaires do not capture the myriad adverse effects on quality of life of corticosteroids such as agitation or poor sleep. To inform the development of a new OCS side effects questionnaire, we sought the views of people with asthma who had taken OCS. An online survey hosted on SurveyMonkey was shared with Asthma UK’s patient network through Facebook (>70k), Twitter (>39k) and the supporter mailing list (>80k). The survey asked people to report their experience of any of 29 symptoms collated from clinical and patient experience, and to report other side-effects not listed. 1,210 people with self-reported asthma responded, 92.5% of whom were on a daily dose of OCS or had had ≥2 asthma attacks requiring OCS in the previous year. The table below shows the 10 most frequently selected side effects and the percentage of respondents who selected each. These findings illustrate the impact of OCS on people with asthma. Results have been used to inform the development of a new side effects questionnaire for use in severe asthma services. It is important that patient-reported side effects are incorporated to fully evaluate clinical effectiveness.