Pulmonology · Public Health · 3 h ago
New Zealand cohort identifies disparities in asthma steroid burden and biologic use
A retrospective national population-based cohort study included 625,450 people with asthma in New Zealand and mapped difficult-to-treat asthma, oral corticosteroid (OCS) exposure and biologic use. The analysis found sociodemographic and regional differences in OCS burden, alongside low biologic use among people classified as having uncontrolled difficult-to-treat asthma.
- 100,017 people met the study’s difficult-to-treat asthma definition.
- 4.7% received at least 500 mg cumulative OCS in 12 months.
- Sociodemographic differences in OCS burden persisted after adjustment.
- Rural areas had lower likelihood but similar total OCS exposure.
Researchers used national dispensing and hospitalisation datasets to identify difficult-to-treat (DTT) asthma, defined by high-dose inhaled corticosteroid plus long-acting beta-agonist dispensings covering at least 90 days in six months. Uncontrolled DTT asthma additionally required at least two OCS dispensings or one asthma hospitalisation during that period. The study included 625,450 people with asthma; 100,017 (16.0%) met the DTT definition, including 9,261 with uncontrolled DTT asthma.
Among the overall asthma population, 4.7% received at least 500 mg cumulative OCS and 1.8% at least 1 g over 12 months. Biologics were used by 1.0% of the reported group. The uncontrolled DTT population was 66% female, 46% from low socioeconomic areas, 22% Māori and 9% Pasifika. Small sociodemographic differences in OCS burden persisted after adjustment for disease severity. Rural areas had a lower likelihood of any OCS exposure but similar total exposure.
The findings describe geographic and sociodemographic variation and may help identify inequities in asthma care. DTT status was an operational proxy for baseline severity, and the observational design does not establish why treatment patterns differed or whether individuals were eligible for biologics.
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ERJ Open Research: Geographical and sociodemographic disparities in oral corticosteroid burden and biologic use in difficult-to-treat asthma: a national population-based cohort study in New Zealand ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.