BURDEN OF SYSTEMIC CORTICOSTEROID UTILIZATION IN COPD

TOPIC: Obstructive Lung Diseases TYPE: Original Investigations PURPOSE: Several studies have shown increased risk of adverse events (AEs) with chronic use oral corticosteroids (OCS) in patients asthma, but patterns OCS use, including overuse and potential OCS-related AEs, not been well characterized the COPD population. This study assessed burden a cohort real-world identified MarketScan Commercial Medicare Supplemental Databases. METHODS: Retrospective analysis diagnosed between November 1, 2017 December 31, 2018. Date first diagnosis was index date. Patients were required to 12 months continuous enrollment before after Patient characteristics, patterns, comorbidities, healthcare resource use/costs described during pre- post-index periods. RESULTS: A total 120,415 identified, 2,898 baseline (mean daily dose ≥10 mg/day last 90 days pre-index period), 117,517 without. Mean age among users 65.2 vs 63.8 y those higher proportion on than without (46% 38%). The mean number claims at 7.0 (SD 4.7) group 1.0 1.8) non-chronic group. Additionally, 41.6% had an burst, defined as ≥20mg prednisone taken over 5–28 days, compared 13.6% users. Across board, rates (all comparisons statistically significant) comorbidities. These included fractures (11.4% 5.3%), osteoporosis (9.1% 3.3%), myocardial infarction (6.8% 3.4%), atrial fibrillation/flutter (13.6% 5.5%), congestive heart failure (19.9% 7.9%), urinary tract infection (11.1% 7.1%), sepsis (13.3% 4.1%), cataracts (6.4% glaucoma (8.3% 4.5%). All-cause utilization significantly Of note, this inpatient admissions (44.3% 25.5%) emergency room visits (54.3% 39.8%). translated all-cause costs $33,864 $14,893 CONCLUSIONS: comorbidity, utilization, costs. Future research is warranted understand whether optimizing treatment can lead reduction use. CLINICAL IMPLICATIONS: Chronic associated significant bone muscle issues, cardiovascular events, infection. Providers should consider reducing dose, when able, or maintenance prevent that would be treated OCS. DISCLOSURES: Employee relationship GSK Please note: current Added 04/23/2021 by Mohan Bangalore, source=Web Response, value=Stocks GlaxoSmithKline >$100000 Michael Bogart, value=Salary IBM Watson Health Donna McMorrow, value=Salarycontracted work value=contracted Elizabeth Packnett, Consultant value=Contracted