按年龄、性别和ICD-10哮喘严重程度划分的大型哮喘人群中三种突出的皮质类固醇副作用的患病率及筛查建议

IF 3.6 4区医学 Q2 PHARMACOLOGY & PHARMACY

Clinical therapeutics Pub Date : 2025-09-01 DOI:10.1016/j.clinthera.2025.06.020

Bowen Yao , Thomas Wilson PhD , Ruitao Zou , Nicholas Orfan MD

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引用次数: 0

摘要

目的：在过去的几十年里，皮质类固醇治疗哮喘的不良反应已经被广泛地记录和探讨。这些不良反应中最突出的是骨质疏松症、白内障和骨坏死。我们评估了350万成人中哮喘患者与非哮喘患者使用皮质类固醇治疗哮喘时这3种众所周知的副作用的发生率。该研究的目的是对特定哮喘人群中上述3种合并症的筛查提出数据驱动的建议。方法：使用科罗拉多州所有付款人索赔数据库，其服务日期为2017年1月1日至2020年6月30日，我们根据哮喘严重程度、年龄和性别确定骨质疏松症、白内障和骨坏死的患病率，并与年龄和性别匹配的非哮喘对照组进行比较。研究结果：哮喘患者一般发病较早，这3种副作用的发生率较高，且与哮喘严重程度相关，与非哮喘比较组的差异往往具有统计学意义。每种副作用的流行模式在年龄和性别方面都是不同的。意义：基于我们的发现，我们建议根据年龄、性别和哮喘严重程度，为哮喘患者的特定亚群定制骨质疏松、白内障和骨坏死筛查指南。

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Prevalence of Three Prominent Corticosteroid Side Effects in a Large Asthma Population by Age, Sex and ICD-10 Asthma Severity with Recommendations for Screening

Purpose

The adverse effects of corticosteroid therapy in the treatment of asthma have been extensively documented and explored over the past several decades. Prominent among these adverse effects are osteoporosis, cataracts, and osteonecrosis. We assessed the prevalence of these 3 well-known side effects of corticosteroid therapy for asthma in asthmatics versus nonasthmatics from a general adult population of 3.5 million individuals. The objective of the study was to make data-driven recommendations regarding screening for the 3 aforementioned comorbidities in specific asthmatic populations.

Methods

Using the Colorado all payers claims database with dates of service January 1, 2017 through June 30, 2020, we determined the prevalence of osteoporosis, cataracts, and osteonecrosis by asthma severity, age, and sex compared with an age and sex matched nonasthmatic comparator group.

Findings

Asthmatics generally showed an earlier onset and higher prevalence of these 3 side effects which correlated with asthma severity, often reaching statistically significant divergence from the nonasthmatic comparator group. Patterns of prevalence with regard to both age and sex were distinctive for each side effect.

Implications

Based on our findings, we suggest customized screening guidelines for osteoporosis, cataracts, and osteonecrosis for specific subpopulations of asthmatics as defined by age, sex, and asthma severity.

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来源期刊

Clinical therapeutics 医学-药学

CiteScore

6.00

自引率

3.10%

发文量

154

审稿时长

9 weeks

期刊介绍： Clinical Therapeutics provides peer-reviewed, rapid publication of recent developments in drug and other therapies as well as in diagnostics, pharmacoeconomics, health policy, treatment outcomes, and innovations in drug and biologics research. In addition Clinical Therapeutics features updates on specific topics collated by expert Topic Editors. Clinical Therapeutics is read by a large international audience of scientists and clinicians in a variety of research, academic, and clinical practice settings. Articles are indexed by all major biomedical abstracting databases.