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Complications and Health Care Resource Utilization Associated with Systemic Corticosteroids in Children and Adolescents with Persistent Asthma.
Sullivan, Patrick W; Ghushchyan, Vahram H; Skoner, David P; LeCocq, Jason; Park, Siyeon; Zeiger, Robert S.
Afiliação
  • Sullivan PW; Department of Pharmacy Practice, Regis University School of Pharmacy, Denver, Colo. Electronic address: psulliva@regis.edu.
  • Ghushchyan VH; Center for Pharmaceutical Outcomes Research, University of Colorado, Aurora, Colo; American University of Armenia, Yerevan, Armenia.
  • Skoner DP; Department of Pediatrics, West Virginia University, Morgantown, WV.
  • LeCocq J; Novartis Pharmaceuticals Corporation, East Hanover, NJ.
  • Park S; Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Md.
  • Zeiger RS; Department of Allergy, Kaiser Permanente, Southern California Region, San Diego, Calif.
J Allergy Clin Immunol Pract ; 9(4): 1541-1551.e9, 2021 04.
Article em En | MEDLINE | ID: mdl-33290914
BACKGROUND: Limited comparative data are available on the impact of systemic corticosteroid (SCS) use in children and adolescents. OBJECTIVE: To determine if asthmatic children and adolescents treated with SCS have a higher likelihood of developing complications versus those not receiving SCS and to examine health care resource utilization (HCRU) in this population. METHODS: A retrospective study of data from children and adolescents with persistent asthma retrieved from the MarketScan database, a large US health claims data set, for the period 2000 to 2017 was performed. Propensity score matching was used to pair patients in the SCS and control cohorts. For complications, SCS subgroups (≥4 or 1-3 annual prescriptions) were compared with asthmatic controls without SCS using logistic regression, and for HCRU, cohorts were compared using negative binomial regression. RESULTS: A total of 67,081 patients were included (SCS: 23,898; control: 43,183). The odds of having a complication were 2.9 (95% confidence interval [CI], 2.5-3.2; P < .001) and 1.6 (95% CI, 1.6-1.7; P < .001) times higher in the ≥4 and 1 to 3 SCS groups, respectively, in the first year of follow-up versus controls. For asthma-related hospitalizations, the incidence rate ratio (IRR) was 6.9 (95% CI, 5.6-8.6) and 3.1 (95% CI, 2.8-3.4) times greater in the ≥4 SCS and 1 to 3 SCS groups, respectively, versus controls; for asthma-related emergency department visits, IRR was 5.0 (95% CI, 4.4-5.6) and 2.9 (95% CI, 2.7-3.0) times greater, respectively, versus controls (all P < .01). CONCLUSION: Children and adolescents receiving SCS for persistent asthma have an increased risk of developing complications and have greater HCRU in the first year of follow-up versus those without SCS exposure.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Asma Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adolescent / Child / Humans Idioma: En Revista: J Allergy Clin Immunol Pract Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Asma Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adolescent / Child / Humans Idioma: En Revista: J Allergy Clin Immunol Pract Ano de publicação: 2021 Tipo de documento: Article