The Burden of Severe Asthma in France: A Case-Control Study Using a Medical Claims Database

Bourdin, Arnaud; Fabry-Vendrand, C.; Ostinelli, J.; Ait-Yahia, M.; Darnal, Elsa; Bouée, S.; Laurendeau, C.; Bureau, Isabelle; Gourmelen, J.; Chouaïd, C.

doi:10.1016/j.jaip.2018.12.029

Cited by 53 publications

(59 citation statements)

References 45 publications

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“…Interestingly, these trials were designed very similarly and were based on primary outcomes nearly identical to those developed for registration studies with ICSs in the 1970s [3]. Surprisingly, in France as in other countries, OCS use is still increasing [12,17]. Chronic airway diseases are by far the most common reason for using OCSs in the short, middle and long term [35].…”

Section: History Of Ocs In Severe Asthmamentioning

confidence: 99%

“…In addition, pivotal OCS-sparing trials with these biologics were successful enough to change guidelines, where these drugs are now cited as 'preferred options' [5]. Nonetheless, surveys reveal that OCSs are still widely used as controllers in about 20% of patients with severe asthma and, most frequently, as rescue medications through repeated bursts using doses suspected to be as toxic as regular use of lower doses, and also in children with severe and nonsevere asthma [10][11][12][13]. Very few prospective and long-term longitudinal studies are available, but it was suggested that this strategy exposed patients to an increased risk of death [14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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How can we minimise the use of regular oral corticosteroids in asthma?

et al. 2020

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Options to achieve oral corticosteroid (OCS)-sparing have been triggering increasing interest since the 1970s because of the side-effects of OCSs, and this has now become achievable with biologics. The Société de Pneumologie de Langue Française workshop on OCSs aimed to conduct a comprehensive review of the basics for OCS use in asthma and issue key research questions. Pharmacology and definition of regular use were reviewed by the first working group (WG1). WG2 examined whether regular OCS use is associated with T2 endotype. WG3 reported on the specificities of the paediatric area. Key “research statement proposals” were suggested by WG4. It was found that the benefits of regular OCS use in asthma outside episodes of exacerbations are poorly supported by the existing evidence. However, complete OCS elimination couldn’t be achieved in any available studies for all patients and the panel felt that it was too early to conclude that regular OCS use could be declared criminal. Repeated or prolonged need for OCS beyond 1 g·year−1 should indicate the need for referral to secondary/tertiary care. A strategic sequential plan aiming at reducing overall exposure to OCS in severe asthma was then held as a conclusion of the workshop.

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Section: History Of Ocs In Severe Asthmamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

How can we minimise the use of regular oral corticosteroids in asthma?

et al. 2020

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“…Although the harmful side-effects of long-term use of SCS are widely known, there seems to be a perception in the medical community that short courses of SCS are safe provided they are used intermittently, rather than continuously. A nationwide cohort study in France reported that 59% of patients with severe asthma were treated with SCS in 2012, with an average frequency of 3.3 courses per patient in the year [23].…”

Section: Use Of Scs In Asthma Managementmentioning

confidence: 99%

Short-course systemic corticosteroids in asthma: striking the balance between efficacy and safety

Price¹,

Castro²,

Bourdin³

et al. 2020

Eur Respir Rev

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Short courses of systemic corticosteroids (SCS), both oral and injectable, are very effective for the resolution of acute asthma symptoms, including exacerbations. However, the benefits of SCS, even short courses, must be balanced against the impact of their side-effects. While the adverse consequences of long-term use are widely recognised, there appears to be a perception in the medical community that short courses of SCS are safe. Limited but growing evidence in the literature suggests that even very brief dosing periods (3–7 days) of SCS are enough to cause significantly negative outcomes for patients. Short courses of SCS are associated with increased risk of adverse events including loss of bone density, hypertension and gastrointestinal ulcers/bleeds, in addition to serious impacts on mental health. Strategies to improve asthma control are recommended, including: 1) as-needed combination therapies in mild asthma; 2) risk factor reduction; 3) improving adherence/inhaler technique; 4) earlier initiation of add-on therapies; 5) use of biologics in appropriate patients; 6) development of new therapies to better control the disease; and 7) widespread education of the medical community. We propose that patients and primary care physicians should consider a cumulative SCS dose of 1 g per year as a highly relevant and easy-to-recall threshold.

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“…From a claims database in France in 2012, the 3-year cumulative mortality rate was markedly higher in SA patients than in patients without asthma (7.1% vs. 4.5%). 18 The asthma mortality data from Korea were initially reported as 0.21 per 100,000 population in 1995, and then decreased to 0.08 in 2006 and 0.04 in 2012. 19 In contrast, a recent analysis of heath claims data and the Statistics Korea database showed that asthma mortality had increased over a decade, with the highest mortality due to SA.…”

Section: Definition Prevalence and Burden Of Samentioning

confidence: 99%

Evaluation and Management of Difficult-to-Treat and Severe Asthma: An Expert Opinion From the Korean Academy of Asthma, Allergy and Clinical Immunology, the Working Group on Severe Asthma

Kim

Park

Ban

et al. 2020

Allergy Asthma Immunol Res

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Severe asthma (SA) presents in about 3%–5% of adult asthmatics and is responsible for over 60% of asthma-related medical expenses, posing a heavy socioeconomic burden. However, to date, a precise definition of or clear diagnostic criteria for SA have not been established, and therefore, it has been challenging for clinicians to diagnose and treat this disease. Currently, novel biologics targeting several molecules, such as immunoglobulin E, interleukin (IL)5, and IL4/IL13, have emerged, and many new drugs are under development. These have brought a paradigm shift in understanding the mechanism of SA and have also provided new treatment options. However, we need to agree on a precise definition of and its diagnostic criteria for SA. Additionally, it is necessary to explain the diagnostic criteria and to summarize current standard and additional treatment options. This review is an experts' opinion on SA from the Korean Academy of Asthma, Allergy, and Clinical Immunology, the Working Group on Severe Asthma, and aims to provide a definition of and diagnostic criteria for SA, and propose future direction for SA diagnosis and management in Korea.

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The Burden of Severe Asthma in France: A Case-Control Study Using a Medical Claims Database

Cited by 53 publications

References 45 publications

How can we minimise the use of regular oral corticosteroids in asthma?

How can we minimise the use of regular oral corticosteroids in asthma?

Short-course systemic corticosteroids in asthma: striking the balance between efficacy and safety

Evaluation and Management of Difficult-to-Treat and Severe Asthma: An Expert Opinion From the Korean Academy of Asthma, Allergy and Clinical Immunology, the Working Group on Severe Asthma

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