SYSTEMIC CORTICOSTEROIDS AND ASSOCIATED COMPLICATIONS FOR PATIENTS WITH PERSISTENT ASTHMA IN THE UNITED STATES: A RETROSPECTIVE ADMINISTRATIVE CLAIMS ANALYSIS

Abstract

SESSION TITLE: Rapid: Novel Therapeutics for Severe Asthma: Looking Closer SESSION TYPE: Original Investigations PRESENTED ON: 10/22/2019 10:45 AM - 11:45 AM PURPOSE: We compared the frequency of chronic complications for patients with persistent asthma who had received systemic corticosteroids (SCS) 1-3 or ≥ 4 times in a year to those who did not use SCS. METHODS: Adult asthma patients with >1 SCS prescription claim (SCS users), and those with an asthma diagnosis but no SCS claims (controls) between 1/2003 and 7/2016, were identified in the IBM® MarketScan® Research Databases. All were enrolled for ≥ 1 year before (baseline) and after the first SCS prescription (SCS users’ index date) or asthma diagnosis (controls’ index date). All patients met ≥1 HEDIS1 criterion for persistent asthma during 1 year pre- and post-index. Those with a transplant, autoimmune disease, or complication of interest during baseline, and those with a non-asthma respiratory disease during baseline or 1 year post-index, were excluded. Patients with 1-3 SCS claims and those with ≥ 4 SCS claims during 1 year post-index were identified. All groups were assessed for 1-5 years for chronic complications associated with SCS use and compared using chi-squared and t-tests. Inverse probability of treatment weights were applied to all comparisons to control for confounders. RESULTS: A total of 86,786 SCS users (76,690 with 1-3 claims; 10,096 with ≥ 4 claims) and 91,409 controls were included, with 22% of the sample remaining 5 years post-index. SCS users with ≥ 4 claims were more likely than controls to have had a chronic complication during 1-5 years; the difference between groups increased consistently from year 1 to 5 (1y: 28% vs. 25%; 2y: 41% vs. 36%; 3y: 50% vs. 43%; 4y: 59% vs. 50%; 5y: 67%-56%, all p<0.05). CONCLUSIONS: Persistent asthma patients with ≥ 4 SCS claims in a year have more chronic complications during 1-5 years vs. similar asthma patients who do not use SCS. The risk of complications for patients with 1-3 SCS claims, relative to controls, increased 3-5 years after SCS initiation. CLINICAL IMPLICATIONS: Alternative treatment strategies that avoid SCS use, or rely on less frequent SCS use, may decrease associated comorbidities and improve health-related quality of life for persistent asthma patients. DISCLOSURES: Employee relationship with AstraZeneca Please note: >$100000 Added 03/12/2019 by Yen Chung, source=Web Response, value=Salary Employee relationship with AsraZeneca Please note: >$100000 Added 03/13/2019 by James Kreindler, source=Web Response, value=Salary Consultant relationship with Astra Zeneca Please note: $5001 - $20000 Added 03/14/2019 by Patrick Sullivan, source=Web Response, value=Consulting fee Consultant relationship with AstraZeneca Please note: >$100000 Added 03/12/2019 by Joseph Tkacz, source=Web Response, value=Grant/Research Support Consultant relationship with Astra Zeneca, Please note: $5001 - $20000 Added 03/12/2019 by Robert Zeiger, source=Web Response, value=Honoraria Consultant relationship with Regeneron Please note: $5001 - $20000 Added 03/12/2019 by Robert Zeiger, source=Web Response, value=Honoraria Consultant relationship with Merck and Co Please note: $5001 - $20000 Added 03/12/2019 by Robert Zeiger, source=Web Response, value=Honoraria Consultant relationship with Sanofi Please note: $5001 - $20000 Added 03/12/2019 by Robert Zeiger, source=Web Response, value=Honoraria Consultant relationship with Novartis Please note: $1001 - $5000 Added 03/12/2019 by Robert Zeiger, source=Web Response, value=Honoraria Board Member relationship with DBV Technologies Please note: $5001 - $20000 Added 03/12/2019 by Robert Zeiger, source=Web Response, value=Honoraria Investigator relationship with Merck and Co Please note: $20001 - $100000 Added 03/12/2019 by Robert Zeiger, source=Web Response, value=Grant/Research Support Investigator relationship with ALK Pharma Please note: $20001 - $100000 Added 03/12/2019 by Robert Zeiger, source=Web Response, value=Grant/Research Support Investigator relationship with AstraZeneca Please note: $5001 - $20000 Added 03/12/2019 by Robert Zeiger, source=Web Response, value=Grant/Research Support No relevant relationships by Nicole Zimmerman, source=Web Response