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Increased Mortality in Patients with Corticosteroid-dependent Asthma: A Nationwide Population-based Study

Title
Increased Mortality in Patients with Corticosteroid-dependent Asthma: A Nationwide Population-based Study
Author
박동원
Keywords
REFRACTORY ASTHMA; HEALTH-CARE; DISEASE; COMPLICATIONS; PREVALENCE; MANAGEMENT; BURDEN; RISK; UK
Issue Date
2019-11
Publisher
EUROPEAN RESPIRATORY SOC JOURNALS LTD
Citation
EUROPEAN RESPIRATORY JOURNAL, v. 54, no. 5, article no. 1900804
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.
URI
https://erj.ersjournals.com/content/54/5/1900804https://repository.hanyang.ac.kr/handle/20.500.11754/153957
ISSN
0903-1936; 1399-3003
DOI
10.1183/13993003.00804-2019
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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