Study to evaluate clinical burden related with oral corticosteroids treatment of severe asthma in Spain (LEVANTE)

2020 
Background: Severe asthma treatment with oral corticosteroids (OCS) added to ICS-LABA combination, may imply poor control, elevated disease burden and increased adverse reactions Aims: Describe the medical burden in patients with severe uncontrolled asthma treated with high doses of ICS-LABA and frequent or chronic OCS use in Spain Methods: This 6-month observational, prospective, multicentre nation-wide study, included adults patients, with severe asthma treated with stable high-dose ICS-LABA, who received (1:2 proportion) OCS over 6 months (maintenance group, n=30, 33.7%) or ≥2 cycles in previous 12 months (course group, n=59, 66.3%) Results: Total N=89 included. Mean age(SD) 56.6(14.6) years, 75.3% female. Mean (SD) time from diagnosis 18.0(16.4) years. Main comorbidities: gastroesophageal reflux 24.7%, chronic rhinosinusitis 36% (nasal polyps 21.3%) and aeroallergen reactivity 33.7%, osteoporosis 10.1% After 6 months, mean(SD) cumulative prednisone equivalent dose in maintenance(n=27) and courses (n=35) were respectively 2169.2(1600.9) mg and 641.3(1029.5) mg Asthma burden in maintenance and courses groups: exacerbations (37.9% and 58.2%, p=0.078), hospitalizations (6.9% and 9.1%) emergency visits (17.2% and 32.7%p=0.130). Mean[SD] events in maintenance and courses: exacerbations (severe 2.0[1.7] and 1.3[1.6], p=0.137; moderate 0.5[1.2] and 1.2[1.5], p=0.097), hospitalizations (8.0[2.8] and 4.0[2.1], p=0.090), emergency visits (2.4[2.6] and 1.4[0.7], p=0.659) Conclusion: The burden of asthma persists without differences between patients receiving maintenance or OCS courses for 6-month follow up
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