Tackling inappropriate OCS usage in severe asthma (ID 523)
GSK, London, UK
Abstract
Background
5–10% of the UK asthma population experiences severe asthma, equivalent to ~200,000 children and adults.1 In emergency settings, oral corticosteroids (OCS) can be lifesaving, but acute and long-term treatment can lead to clinically important adverse outcomes, increase mortality risk and higher healthcare resource utilisation. Despite the risks, a UK-specific publication highlighted substantial OCS exposure in the UK with the median number of OCS courses being 5 in the previous 12-months.1
There is an urgent need to align thinking away from OCS over-reliance and ensure primary and secondary care clinicians can confidently recognise and refer people with suspected severe asthma for specialist review.
Method
A summit was held as a collaborative effort to generate a series of patient- and clinician-focused initiatives to protect patients with severe asthma from inappropriate OCS use. The meeting’s objectives were to demonstrate the need for OCS Stewardship and policy change in severe asthma to reduce OCS prescribing by highlighting current burden with OCS overuse, discussing approaches to assessing OCS exposure, OCS-related toxicities, and practical tools/actions to prevent future OCS related adverse effects.
Results
25 people attended the summit, with 10 panel-members representing respiratory, endocrinology, general practitioners, consultant pharmacists, nurse consultant, patient organisation representatives and an expert patient.
Recommendations from the workshop were grouped into themes: HCP & patient education (e.g., antibiotic-like patient education, emergency/rescue therapy awareness), intermediate care (e.g., increasing collaboration), biomarker testing (risk-stratifying patients), and other (e.g., dispensing records, protocolised weaning).
Conclusions
Implementing these changes will result in positive health outcomes for patients. Changes to national and local policies and HCP collaboration across multi-disciplinary primary/secondary/specialist care are crucial to achieving this goal.
References
1. McDowell PJ et al; Clinical remission in severe asthma with biologic therapy: an analysis from the UK Severe Asthma Registry. EurRespirJ. 2023 Dec 14;62(6):2300819
Funding: Funded by GSK
Conflicts of interest: Conflicts of interest statements:
• Nadia Malik is employed by GSK and holds financial equities in GSK
• Tom Fardon has received speaker/lecture fees from GSK and AstraZeneca; received meeting/conference travel funding from GSK and AstraZeneca; and attended an advisory board for Astra Zeneca as an unpaid participant.
• Shoaib Faruqi has received honoraria for speaking at educational meetings supported or organised by GSK, AZ, Chiesi, Novartis, Sanofi
• Liam Heaney is the Academic Lead for the UK MRC Consortium for Stratified Medicine in Severe Asthma; received speaker/lecture fees from AZ, Sanofi, Circassa, GSK and Teva; has received grant funding from GSK and AZ; been involved in clinical trials with GSK, AZ and Roche/Genentech; has received travel funding from AZ, Sanofi, Teva and GSK; participated in advisory boards for GSK, AZ and Celltrion
• Katherine Hickman is the primary care lead for National Respiratory Audit Programme and the respiratory lead for West Yorkshire and has no other conflicts of interest.
• Andrew Whittamore is the clinical lead for Asthma and Lung UK; worked with Sanofi and AZ as part of Asthma and Lung UK joint working agreement; received speaker/lecture fees from GSK, NIOX (formely Circassa), Sanofi and Chiesi; received conference travel funding from NAPP and Chiesi; study advice and manuscript writing services for Chiesi.
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