Complications related to oral corticosteroid use in asthma patients: a retrospective cohort study

Asthma patients requiring oral corticosteroids (OCS) are at increased risk of adverse effects. Research focusing on asthma patients adhering to guideline-directed therapy remains limited. This study evaluates the adverse effects of corticosteroids in asthma patients treated with high-dose inhaled corticosteroids (ICS) who required additional OCS due to inadequate disease control.

We conducted a retrospective cohort study of asthma patients from Taiwan's asthma pay-for-performance program, who had used high-dose ICS for at least 90 days, categorizing them based on OCS use. In the short-term period (3 months), patients were classified into a control group (no OCS) and an OCS group (≥450 mg OCS within 90 days). In the long-term period (6 months), the OCS group consisted of patients receiving ≥ 900 mg OCS within 180 days.

A total of 173,835 patients were enrolled for analysis. We assessed the risks of osteoporosis, diabetes, hypertension, infections, cardiovascular diseases, mental health disorders, and ocular conditions. Both short- and long-term OCS users exhibited significantly higher risks of these adverse outcomes compared to the control group.

These findings highlight the substantial health risks associated with OCS. Clinicians should carefully consider alternative strategies to minimize harm while ensuring effective disease control.