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Systemic Corticosteroid Dispensing Patterns Among Patients with Sinonasal Polyps: A Population-Based Retrospective
Laura Valle Soto1, Amee Manges2, Anne Gadermann2
1Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada.
Summary
Systemic corticosteroids (SCS) dispensing for chronic rhinosinusitis with nasal polyps (CRSwNP) varied significantly, potentially leading to unequal adverse outcome risks. Standardized guidelines are needed for appropriate SCS use in CRSwNP patients.
Area of Science:
- Otolaryngology
- Pharmacology
- Public Health
Background:
- Systemic corticosteroids (SCS) are frequently used for chronic rhinosinusitis with nasal polyps (CRSwNP).
- Evidence suggests a dose-response relationship between SCS and adverse outcomes, even at low cumulative doses.
- Standardized guidelines for SCS use in CRSwNP are lacking.
Purpose of the Study:
- To investigate SCS dispensing patterns in CRSwNP patients.
- To identify factors associated with high cumulative SCS exposure.
- To evaluate prescribing practices for SCS in CRSwNP.
Main Methods:
- Population-based retrospective cohort study using pharmacy claims data (2012-2022).
- Included CRSwNP patients from British Columbia, Canada.
- Analyzed cumulative SCS doses, course characteristics, and prescriber patterns.
Main Results:
- 21.8% of 7000 CRSwNP patients received ≥1 gram of SCS.
- High SCS exposure was more prevalent in rural areas and those with comorbid respiratory conditions.
- General practitioners were the most frequent prescribers; otolaryngologists showed inconsistent prednisone prescribing.
Conclusions:
- Unwarranted variation in SCS dispensing exists for CRSwNP patients.
- This variation may lead to differential exposure to SCS-related adverse events.
- Clinical guidelines are essential to standardize SCS use and optimize patient outcomes.
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