One-day systemic corticosteroid administration for asthma and future “short bursts” risk in real clinical practice

Abstract

Objective

Systemic corticosteroid administration, also called short bursts (SB), is harmful for patients with asthma; however, the actual burden of one-day SB remains unsolved. This study aimed to elucidate the characteristics of patients requiring one-day SB against asthma in clinical practice.

Methods

Consecutive patients who regularly visited our hospital for asthma treatment between January 2019 and December 2020 were reviewed and followed for one year. SB was defined as ≥3 days of systemic corticosteroid treatment for an exacerbation. One-day SB was defined as one-day of systemic corticosteroid to treat an exacerbation. The one-day SB group included patients who received only one-day SB but no SB during the preceding year. Frequent SB was defined as that occurring ≥2 times/year.

Results

Data on 229 patients were analyzed. Among them, 2.6% (95% confidence interval 1.2–5.6%) were in the one-day SB group. The one-day SB group was female-dominant, obese, non-eosinophilic, and non-atopic. The median one-day SB was 1.5 times/year and almost half of one-day SB were performed by patients themselves. Independent of the low pulmonary function, high blood eosinophil count, and inhaled corticosteroid dose, one-day SB was associated with future frequent SB (adjusted odds ratio = 18.2, 95% confidence interval 1.1–288, P = 0.040, compared to the no SB group).

Conclusions

Although one-day SB was not frequently experienced, even one-day SB without conventional SB was associated with future frequent SB. It is important to grasp the actual condition of one-day SB and to reinforce the treatment used.

Keywords:

• Exacerbation
• one-day short burst
• conventional short burst
• real world
• inner-city hospital

Acknowledgements

The authors thank the doctor’s assistants for the data collection. The authors also thank Enago (www.enago.jp) for the English language review.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.