Systemic Corticosteroids in Patients with Bronchial Asthma:
A Real-Life Study

It presents a real-world use of systemic corti-costeroids (SCs) in bronchial asthma patients from the entire population with available Electronic Medical Records (EMRs) within the Castilla-La Mancha Health Care Network (SESCAM) using big data analysis tools and artificial intelligence systems (Savana Manager).

By analyzing 2.707.587 patients with EMRs of which 103.667 were asthma patients, the study concludes that SCs are prescribed much more frequently than recommended in current guidelines. The use of SCs is associated with a greater number of adverse events in clinical practice, therefore, applying Natural Language Processing (NLP) and machine learning to analyze EHRs of bronchial asthma patients has offered valuable insights, unveiling it is necessary to implement measures to reduce prescription of SCs to patients with asthma, especially in primary care.

To highlight, this is an independent study conducted by Dr. Izquierdo, Head of Pneumology at Guadalajara Hospital and University Prof. at Alcalá University, and his team by themselves and in their own time. Performing their analysis via the clinical platform Savana Manager ®.

infographic bronchia asthma publication

Abstract

The objective of the present study was to determine the use of systemic corti-costeroids in patients with bronchial asthma using big data analysis.

We performed an observational, retrospective, noninterventional study based on secondary data captured from free text in the electronic health records. This study was per-formed based on data from the regional health service of Castille-La Mancha (SESCAM), Spain. We performed the analysis using Big Data and Artificial Intelligence via Savana Manager ® version 3.0.

During the study period, 103 667 patients were diagnosed with and treated for asthma at different care levels.

The search was restricted to patients aged 10 to 90 years (mean age, 43.5 [95%CI, 43.4-43.7] years). Of these, 59.8% were women. Systemic corti-costeroids (SCs) were taken for treatment of asthma by 58 745 patients at some point during the study period. These patients were older, with a higher prevalence of hypertension, dyslipidemia, diabetes, ob-esity, depression, and hiatus hernia.

SCs are used frequently in the general population with asthma (31.4% in 2015 and 39.6% in 2019). SCs were prescribed mainly in primary care (59%), allergy (13%) and pulmonology (20%). The frequency of prescription of SCs had a direct impact on the main associated adverse effects.

In clinical practice, SCs are frequently prescribed to patients with asthma, especially in primary care. Use of SCs is associated with a greater number of adverse events.

It is necessary to implement measures to reduce prescription of SCs to patients with asthma, especially in primary care.