Patterns of Use and Possible Complications of Oral Corticosteroids for the Management of Asthma in the Colombian Health System

Main Article Content

Ángela Viviana Pérez Gómez
https://orcid.org/0000-0001-6272-0626
Liz Garavito Beltrán
https://orcid.org/0009-0005-3271-6104
Luz Adriana Moyano
https://orcid.org/0009-0007-4537-0290
Carlos Andres Celis Preciado
https://orcid.org/0000-0001-8405-4513
Luisa Fernanda Manrique
Audrey Piotrostanalzki
https://orcid.org/0009-0004-4372-1366
Robin Alonso Rada Escobar
https://orcid.org/0000-0001-6043-6920
Abraham Alí Munive
https://orcid.org/0000-0003-2153-0492

Abstract

Introduction: Asthma, characterized by chronic airway inflammation, is primarily treated with inhaled corticosteroids and other medications based on disease severity. For the past 60 years, systemic corticosteroids have been used to treat asthma attacks in patients who do not respond to standard therapy. However, this approach is associated with adverse effects. 


Methods: This study, based on medical records, aimed to describe the frequency of oral corticosteroid (OC) use in asthma patients. 


Results: A pattern of OC overuse was identified, possibly related to the lack of clarity regarding prescription criteria and time of use. In addition, the presence of possible adverse effects associated with the use of OC was documented. 


Conclusion: This shows the need to precisely define the indications for and restrictions to applying this therapy, to encourage optimal control management to avoid asthmatic crisis, and carry out a strict clinical follow-up of patients requiring the use of OC.

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How to Cite
Pérez Gómez , Ángela V. ., Garavito Beltrán , L. ., Moyano, L. A. ., Celis Preciado , C. A. ., Manrique , L. F. ., Piotrostanalzki , A. ., Rada Escobar , R. A., & Alí Munive, A. . (2024). Patterns of Use and Possible Complications of Oral Corticosteroids for the Management of Asthma in the Colombian Health System. Respirar, 16(4), 341–355. https://doi.org/10.55720/respirar.16.4.2
Section
Artículos Originales
Author Biographies

Ángela Viviana Pérez Gómez , Processum Consultoría Institucional SAS. Bogotá, Colombia

Médica, MsC epidemiologia clínica. 

Liz Garavito Beltrán , Processum Consultoría Institucional SAS. Bogotá, Colombia

Ingeniera Industrial, Magister en Economía 

Luz Adriana Moyano, Processum Consultoría Institucional SAS. Bogotá, Colombia

Data Engineering Leader

Carlos Andres Celis Preciado , Pontificia Universidad Javeriana. Bogotá, Colombia.

Neumologo 

Luisa Fernanda Manrique , Centro Médico Especializado en Medicina del Ejercicio (CEMDE), Unidad Neumología. Medellín, Colombia.

Neumologa 

Robin Alonso Rada Escobar , Hospital Militar Central. Bogotá, Colombia.

Neumologo

Abraham Alí Munive, Fundación Neumológica Colombiana. Bogotá, Colombia.

Neumologo

References

Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2023. [Internet].[Consultado 11 ago 2023]. Disponible en: https://ginasthma.org/wp-content/uploads/2023/07/GINA-2023-Full-report-23_07_06-WMS.pdf

Al Efraij K, Johnson KM, Wiebe D, Sadatsafavi M, FitzGerald JM. A systematic review of the adverse events and economic impact associated with oral corticosteroids in asthma. J Asthma 2019;56(12):1334–46. Doi: 10.1080/02770903.2018.1539100.

Manson SC, Brown RE, Cerulli A, Vidaurre CF. The cumulative burden of oral corticosteroid side effects and the economic implications of steroid use. Vol. 103, Respir Med 2009;103(7):975-94. Doi: 10.1016/j.rmed.2009.01.003.

Price D, Castro M, Bourdin A, Fucile S, Altman P. Short-course systemic corticosteroids in asthma: Striking the balance between efficacy and safety. Eur Respir Rev 2020;29(155):190151. Doi: 10.1183/16000617.0151-2019.

Tran TN, King E, Sarkar R et al. Oral corticosteroid prescription patterns for asthma in France, Germany, Italy and the UK. Eur Resp J 2020;55(6). Doi: 10.1183/13993003.02363-2019.

Bleecker ER, Menzies-Gow AN, Price DB et al. Systematic literature review of systemic corticosteroid use for asthma management. Am J Respir Crit Care Med 2020;201(3):276–93. Doi: 10.1164/rccm.201904-0903SO.

Heatley H, Tran TN, Bourdin A et al. Observational UK cohort study to describe intermittent oral corticosteroid prescribing patterns and their association with adverse outcomes in asthma. Thorax 2023;78(9):860-867. Doi: 10.1136/thorax-2022-219642.

Van Der Goes MC, Jacobs JW, Bijlsma JW. The value of glucococrticoid co-therapy in different rheumatic diseases - positive and adverse effects. Arthritis Res Ther. 2014;16 Suppl 2(Suppl 2):S2. Doi: 10.1186/ar4686.

Zazzali JL, Broder MS, Omachi TA, Chang E, Sun GH, Raimundo K. Risk of corticosteroid-related adverse events in asthma patients with high oral corticosteroid use. Allergy Asthma Proc 2015;36(4):268–74. Doi: 10.2500/aap.2015.36.3863.

Ekström M, Nwaru BI, Hasvold P, Wiklund F, Telg G, Janson C. Oral corticosteroid use, morbidity and mortality in asthma: A nationwide prospective cohort study in Sweden. Allergy 2019;74(11):2181–90. Doi: 10.1111/all.13874.

Bullard MJ, Liaw SJ, Tsai YH, Min HP. Early corticosteroid use in acute exacerbations of chronic airflow obstruction. Am J Emerg Med 1996;14(2):139–43. Doi: 10.1016/S0735-6757(96)90120-5.

Chung LP, Upham JW, Bardin PG, Hew M. Rational oral corticosteroid use in adult severe asthma: A narrative review. Respirology 2020;25(2):161–72. Doi: 10.1111/resp.13730.