Age and Sex Associations with Systemic Corticosteroid-Induced Morbidity in Asthma
Age and Sex Associations with Systemic Corticosteroid-Induced Morbidity in Asthma
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DOI：
10.1016/j.jaip.2018.04.008
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发表时间：
2018-11-01
影响因子：
9.4
通讯作者：
Heaney, Liam G.
中科院分区：
文献类型：
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作者：
Barry, Luke E.;O'Neill, Ciaran;Heaney, Liam G.
背景：重度哮喘的治疗可能包括大剂量全身性皮质类固醇治疗，这与大量合并症有关。有证据表明，这种负担是不均匀分布在不同年龄，性别和皮质类固醇暴露levels.Objective：检查年龄，性别，合并症之间的关联，和模式的卫生保健费用在群体区分皮质类固醇暴露。重度哮喘患者（n = 808）与轻度/中度哮喘患者按年龄和性别匹配（n = 3975）和非哮喘对照受试者（n = 2412）。回归分析用于研究多种皮质类固醇诱导的合并症的几率，因为它因队列、年龄组和性别而异。处方药和公共资助的卫生保健活动被货币化，估计每个病人的年成本。结果：60岁或60岁以下的高口服皮质类固醇（OCS）暴露的患者骨质减少、骨质疏松、青光眼、消化不良、慢性肾脏疾病、心血管疾病、白内障、高血压和肥胖的几率更大（P
BACKGROUND: Treatment of severe asthma may include highdose systemic corticosteroid therapy, which is associated with substantial comorbidity. There is evidence to suggest that this burden is not evenly distributed across age, sex, and corticosteroid exposure levels.OBJECTIVE: To examine the associations between age, sex, comorbidity, and patterns of health care cost across groups differentiated by corticosteroid exposure.METHODS: Patients with severe asthma (n = 808) were matched by age and sex with patients with mild/moderate asthma (n = 3975) and nonasthma control subjects (n = 2412) from the Optimum Patient Care Research Database. Regression analysis was used to investigate the odds of a number of corticosteroid-induced comorbidities as it varied by cohort, age group, and sex. Prescribed drugs and publicly funded health care activity were monetized and annual costs per patient estimated.RESULTS: Patients aged 60 years or younger with high oral corticosteroid (OCS) exposure had greater odds of osteopenia, osteoporosis, glaucoma, dyspeptic disorders, chronic kidney disease, cardiovascular disease, cataracts, hypertension, and obesity (P