OBJECTIVES: To examine the adverse effects of oral corticosteroid (OCS) on elderly asthma patients in South Korea, we aimed to estimate the prevalence and odds of potential OCS-related comorbidities in OCS-dependent asthma patients compared with patients who did not use OCS.

METHODS: A cross-sectional study was performed using the Health Insurance Review and Assessment Service-National Patient Sample 2020. We included patients aged ≥60 years with OCS-dependent asthma, satisfying all following criteria: (1) ≥1 claim of asthma diagnosis (ICD-10: J45-46) (2) ≥5 mg/day prednisolone equivalents use for ≥90 days in a year. No-OCS asthma patients were also defined for comparison: ≥1 claim of asthma diagnosis and having no prescription record of OCS in 2020. Prevalence rates of potential OCS-related comorbidities were evaluated for each group. We used binary logistic regression to estimate the odds ratio (OR), 95% confidence interval (CI), and p-value for the OCS-dependent patients relative to no-OCS asthma patients. A p-value of <0.05 was considered statistically significant.

RESULTS: Overall, 898 OCS-dependent asthma patients and 12,695 no-OCS asthma patients were included. The odds of congestive heart failure comorbidities (OR, 1.63; 95% CI, 1.39-1.90; p<0.0001), peripheral vascular comorbidities (OR, 1.30 95% CI, 1.12-1.50; p=0.0005), rheumatologic comorbidities (OR, 3.60; 95% CI, 2.95-4.38; p<0.0001), peptic ulcer comorbidities (OR, 1.65; 95% CI, 1.43-1.89; p<0.0001), renal comorbidities (OR, 1.62; 95% CI, 1.29-2.04; p<0.0001), type 2 diabetes comorbidities (OR, 1.16; 95% CI, 1.01-1.33; p=0.0328), osteoporosis comorbidities (OR, 1.88; 95% CI, 1.61-2.19; p<0.0001), glaucoma comorbidities (OR, 1.26; 95% CI, 1.08-1.49; p=0.0042) and hypercholesterolemia comorbidities (OR, 1.21; 95% CI, 1.05-1.40; p=0.009) were significantly higher in the OCS-dependent asthma patients in comparison with no-OCS asthma patients.

CONCLUSIONS: OCS-dependent asthma was associated with higher odds of comorbidities in the elderly. Alternative treatment strategies are needed to reduce the adverse effects of OCS on elderly asthma patients.