The Risk of Osteoporotic Fractures in Elderly Asthmatic Patients According to Prescribing Patterns of Systemic Corticosteroid in South Korea

Speaker(s)

Suh HS1, Pyun D2
1College of Pharmacy, Kyung Hee University, Department of Regulatory Science, Graduate School, Kyung Hee University, Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, Korea, Republic of (South), 2Department of Regulatory Science, Graduate School, Kyung Hee University, Institute of Regulatory Innovation through Science, Kyung Hee University, Seoul, South Korea

Presentation Documents

OBJECTIVES: Osteoporotic fractures (OFs) are growing concern among elderly asthmatic patients undergoing systemic corticosteroid (SCS) therapies. While the impact of cumulative SCS dosage on adverse events is acknowledged, there has been lack of research on elderly asthmatic patients in South Korea. This study aimed to assess the incidence and risk of OFs in elderly asthmatic patients, considering duration and cumulative dosage of SCS.

METHODS: We conducted a retrospective cohort study using claims data from the Health Insurance Review and Assessment Service. The cohort included individuals aged 65 or older diagnosed with asthma and receiving asthma medications in 2016. Patients exceeding a cumulative dose of 450mg prednisolone equivalents within six months were included. They were divided into two groups: the low-intensity group (>90 days with cumulative dose >450mg) and the high-intensity group (≤90 days with the same cumulative dose). Propensity score matching (PSM) method was applied to control confounders between two groups. After PSM, Cox proportional hazard model was used to assess the risk of OFs.

RESULTS: Among 6,342 eligible patients, 1,951 were in the low-intensity group, and 4,391 in the high-intensity group. Following PSM, each group contained 1,783 patients. The incidence rate of OF was 52.58 per 1,000 person-years in the low-intensity group and 50.18 per 1,000 person-years in the high-intensity group. The hazard ratio of OF for the high-intensity group compared with the low-intensity group was 0.948 (95% confidence interval, 0.780 to 1.151; p=0.5873).

CONCLUSIONS: In our study, the high-intensity group and low-intensity group showed similar incidence rates of OFs, and no significant difference in the risk of OF was observed. These results suggest that careful consideration should be given to the occurrence of OFs in patients with both groups. The findings of our study can serve as a basis for studies about adverse event of SCS, and contribute to health insurance planning.

Code

HPR131

Topic

Epidemiology & Public Health

Topic Subcategory

Disease Classification & Coding, Public Health, Safety & Pharmacoepidemiology

Disease

Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)