Abstract
Introduction Chronic systemic corticosteroid (CS) therapy is associated with an increased risk of mortality in patients with many chronic diseases. However, it has not been elucidated whether chronic systemic CS therapy is associated with increased mortality in patients with asthma. The aim of this study was to determine the effects of chronic systemic CS therapy on long-term mortality in adult patients with asthma.
Methods A population-based matched cohort study of males and females aged ≥18 years with asthma was performed using the Korean National Health Insurance Service database from 2005 to 2015. Hazard ratio (HR) with 95% confidence interval for all-cause mortality among patients in the CS-dependent cohort (CS use ≥6 months during baseline period) relative to those in the CS-independent cohort (CS use <6 months during baseline period) was evaluated.
Results The baseline cohort included 466 941 patients with asthma, of whom 8334 were CS-dependent and 458 607 were CS-independent. After 1:1 matching, 8334 subjects with CS-independent asthma were identified. The HR of mortality associated with CS-dependent asthma relative to CS-independent asthma was 2.17 (95% CI 2.04–2.31). In patients receiving low-dose CS, the HR was 1.84 (95% CI 1.69–2.00); in patients receiving high-dose CS, the HR was 2.56 (95% CI 2.35–2.80).
Conclusions In this real-world, clinical practice, observational study, chronic use of systemic CS was associated with increased risk of mortality in patients with asthma, with a significant dose–response relationship between systemic CS use and long-term mortality.
Abstract
Chronic use of systemic corticosteroid (CS) was associated with increased risk of mortality in patients with asthma, with a significant dose–response relationship between systemic CS use and long-term mortality http://bit.ly/2ku3ZJl
Footnotes
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Author contributions: Literature search: all authors; study design: H. Lee, J. Ryu, E. Nam, J-Y. Moon, H.J. Yoon and S-H. Kim; data analysis: H. Lee, J. Ryu, E. Nam and S-H. Kim; data interpretation: all authors; writing: H. Lee, J. Ryu, E. Nam and S-H. Kim; tables and figures: H. Lee, J. Ryu and S-H. Kim.
Conflict of interest: H. Lee has nothing to disclose.
Conflict of interest: J. Ryu has nothing to disclose.
Conflict of interest: E. Nam has nothing to disclose.
Conflict of interest: S.J. Chung has nothing to disclose.
Conflict of interest: Y. Yeo has nothing to disclose.
Conflict of interest: D.W. Park has nothing to disclose.
Conflict of interest: T.S. Park has nothing to disclose.
Conflict of interest: J-Y. Moon has nothing to disclose.
Conflict of interest: T-H. Kim has nothing to disclose.
Conflict of interest: J.W. Sohn has nothing to disclose.
Conflict of interest: H.J. Yoon has nothing to disclose.
Conflict of interest: S-H. Kim has nothing to disclose.
Support statement: This study was funded by the Korea Ministry of Environment (MOE) as the Environmental Health Action Program (2016001360003) and a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health and Welfare, Korea (HI19C0218). The Korea MOE and KHIDI played no role in the design of the study, analysis and interpretation of data, and writing the current manuscript. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received April 21, 2019.
- Accepted August 28, 2019.
- Copyright ©ERS 2019
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