Patients Report Myriad Side Effects With Use of Oral Corticosteroids for Severe Asthma

By Jenny Powers

PARIS -- September 19, 2018 -- In response to an online survey, 1,210 people with severe asthma who had used oral corticosteroids reported quality of life (QoL) issues that are often overlooked by conventional assessment tools, according to findings presented here at the 2018 International Congress of the European Respiratory Society (ERS).

Side effects mentioned included weight gain, anxiety, and heightened emotional moods.

“Clinicians themselves underestimate the frequency of side effects in asthma patients,” remarked Catherine Broadbent, MSc, BSc, Asthma UK, London, United Kingdom, on September 17.

Broadbent and colleagues designed an online survey asking patients to select the most important side effects of the drugs they take for asthma. Responses indicated that the 6 most frequently listed effects included weight gain (56.4%), difficulty falling asleep at night (54.7%), eating more (53.3%), becoming upset and tearful more easily (43.4%), irritability (43.3%), and bruising easily (42.2%). In addition, 40.5% of respondents reported that they had increased food cravings, 37.2% said they felt more anxious, and 37.0% said they had less energy when taking oral corticosteroids.

In an open text box, a total of 405 respondents (33.5%) reported more side effects than were contained in the survey.

In all, 79% of patients said that oral corticosteroids had effects on or caused other health conditions. Mental health was affected according to 65% of respondents. A total of 365 participants said that the drugs affected their skin, hair, and teeth, and 29% said their sleep was affected.

Additional issues raised by respondents included effects on their eyes (20%), and 9% of patients mentioned circulatory effects with corticosteroid use.

Of the respondents, 92.5% were currently on a daily dose of corticosteroids or had had ≥2 asthma attacks requiring treatment with oral corticosteroids within the previous year.

“We sought…to inform the development of a new side-effects questionnaire to more accurately gauge this aspect of oral corticosteroids. The responses were collated into a new QoL instrument,” Broadbent explained.

The online survey was hosted on SurveyMonkey and distributed to Asthma UK’s patient network via the supporter mailing list, Facebook, and Twitter.
“Existing questionnaires, such as the Asthma Control Questionnaire and the Asthma Quality of Life Questionnaire, fall short of capturing the myriad adverse effects on QoL that people experience with corticosteroids, such as agitation or poor sleep,” noted Broadbent.

“These results are being used to inform the development of a new side-effects questionnaire for use in severe asthma services. It is important that patient-reported side effects are incorporated to fully evaluate clinical effectiveness,” the researchers concluded.

The team is in the process of validating this questionnaire, with the aim of creating a new outcomes measure that can be used in clinical trials.

[Presentation title:Patient-Reported Side Effects of Oral Corticosteroids. Abstract PA2614]
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