Almost a third of patients with severe asthma are taking potentially harmful doses of oral steroids, according to a Dutch study presented at the 2019 ERS Congress.
The study used a pharmacy database of more than 500,000 Dutch residents to identify patients with severe asthma – those using high doses of inhaled corticosteroids plus long-acting beta agonists.
The database also included information on oral corticosteroids and adherence to medication.
Dr Katrien Eger, a PhD candidate and pulmonologist in training at the Amsterdam University Medical Centre, told the Congress that 29% of asthma patients using ICS/LABA combinations were also using oral steroids at doses ≥420 mg.
The median dose was 750 mg/year – the equivalent of about four rescue doses.
The study found about 78% of high oral corticosteroid users either had suboptimal adherence or suboptimal inhalation technique – providing scope to reduce their reliance on oral corticosteroids.
However beyond that, 21.9% of patients who still required oral corticosteroids to control their asthma could be given a trial of biologic therapy.
Dr Eger said that in extrapolating from their database to the general Dutch population, about 6,000 patients with severe asthma were candidates for biologics yet fewer than half were receiving them.