Oral steroid warning for asthma patients

Too many people with severe asthma are at risk through the use of oral steroids, a major European conference will hear today.

An observational study was carried out by Dr Katrien Eger and her team at Amsterdam University in The Netherlands. They analysed a pharmacy database of 500,500 Dutch people and found 5,002 people with asthma who were taking 500 micrograms or more a day of inhaled corticosteroids and long-acting beta agonists.

Questionnaires were sent to these patients and 2,312 were returned. Findings are presented today (2 October) at the European Respiratory Society International Congress in Madrid, Spain.

Analysis showed that a third of patients were taking harmful doses of oral steroids. It also suggested that most of these patients could avoid taking oral steroids by improving their adherence to their other asthma medication and their inhaler technique.

In addition, the researchers found that many patients who might be eligible for treatment with new biologic asthma drugs are not yet receiving them.

Dr Eger said: “Asthma patients using high doses of oral steroids are at risk of serious adverse effects such as diabetes, osteoporosis and adrenal insufficiency, in which the adrenal glands do not produce adequate amounts of steroid hormones.

“Our findings show that many patients with severe asthma are taking harmfully high doses of oral steroids. Every prescription for oral steroids should alert doctors to assess adherence to inhaled therapies and inhalation techniques in these patients.

“Furthermore, now that there is an increasing number of biologic asthma drugs available that avoid the need for oral steroids, doctors should initiate biologic treatment in suitable patients to reduce exposure to harmful oral steroids.”

Abstract no: OA5334, “Overuse of oral corticosteroids in asthma – modifiable factors and potential role of biologics”, by Katrien A.B. Eger et al is presented on Wednesday 2 October 2019 at the European Respiratory Society International Congress in Madrid, Spain, from 28 September to 2 October 2019.