Limited comparative data are available on impact of systemic corticosteroid (SCS) use in children and adolescents.
To determine if asthmatic children and adolescents treated with SCS have a higher likelihood of developing complications versus those not receiving SCS and to examine healthcare resource utilization (HCRU) in this population.
A retrospective study of children and adolescents with persistent asthma in the 2000-2017 MarketScan database, a large US health claims data set. Propensity score matching was used to pair patients in the SCS and control cohorts. For complications, SCS subgroups (≥4 or 1-3 annual prescriptions) were compared with asthmatic controls without SCS using logistic regression; and for HCRU, cohorts were compared using negative binomial regression.
67,081 patients were included (SCS: 23,898; control: 43,183). The odds of having a complication were 2.9 (95% CI 2.5-3.2; P<.001) and 1.6 (95% CI 1.6-1.7; P<.001) times higher in the ≥4 and 1-3 SCS groups, respectively, in the first year of follow-up versus controls. For asthma-related hospitalizations, incidence rate ratio (IRR) was 6.9 (95% CI 5.6-8.6) and 3.1 (95% CI 2.8-3.4) times greater in the ≥4 SCS and 1-3 SCS groups, respectively, versus controls; for asthma-related ED visits, IRR was 5.0 (95% CI 4.4-5.6) and 2.9 (95% CI 2.7-3.0) times greater, respectively, versus controls (all P<.01).
Children and adolescents receiving SCS for persistent asthma have an increased risk of developing complications and have greater HCRU in the first year of follow-up versus those without SCS exposure.

Copyright © 2020. Published by Elsevier Inc.