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Health-related quality of life associated with systemic corticosteroids

Quality of Life Research Aims and scope Submit manuscript

Abstract

Background

Systemic corticosteroids (SCS) are commonly used but are associated with adverse effects. Given their prevalent use, the potential impact of SCS use on health-related quality of life (HRQoL) is important to characterize.

Objective

To assess the HRQoL of patients taking SCS.

Methods

The 2000–2003 Medical Expenditure Panel Survey was used to examine EQ-5D and SF-6D scores associated with SCS use in adults. The study sample was restricted to those with a condition for which SCS are prescribed. SCS use was categorized into three levels: none; 1–3; and ≥4 prescriptions per year. HRQoL scores were regressed on SCS use (1–3 or ≥4 annual prescriptions) controlling for age, gender, race, ethnicity, education, income category, geographic region, number of ER visits, number of outpatient visits, total number of chronic conditions (for which SCS are not used) and conditions for which SCS are clinically indicated.

Results

There were 54,856 individuals with no SCS exposure, 2245 with 1–3 and 624 with ≥4 annual SCS prescriptions. In adjusted analyses, use of ≥4 annual SCS prescriptions appeared to be associated with significantly lower EQ-5D (US), EQ-5D (UK), SF-6D and EQ-5D VAS scores compared to no exposure: −0.032, −0.047, −0.036, and −7.58.

Conclusion

While SCS are efficacious and widely used for numerous conditions, results suggest that their use may be associated with a substantial deleterious impact on HRQoL. This potential negative effect should be considered in balance with the cost and efficacy of comparable treatments.

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Funding

This study was funded by a research grant from Amgen, Inc.

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Patrick W. Sullivan.

Ethics declarations

Conflict of interest

Dr. Sullivan has received research grants from Amgen, Inc. Dr. Globe is an employee and stockholder of Amgen, Inc. Dr. Ghushchyan declares that he has no conflict of interest. Dr. Sucher declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Appendix

Appendix

See Appendix Tables 6, 7, 8, 9, 10, 11 and 12.

Table 6 Number of individuals reporting the most prevalent 30 conditions with indications for SCS in MEPS 2000–2003
Table 7 Full regression results EQ-5D (UK) CLAD
Table 8 Full regression results EQ-5D (US) CLAD
Table 9 Full regression results SF-6D CLAD
Table 10 Full regression results VAS OLS
Table 11 Conditions with indications for SCS in MEPS
Table 12 Baseline sociodemographic characteristics (MEPS 2000–2012: SF-6D Sample)

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Sullivan, P.W., Ghushchyan, V.H., Globe, G. et al. Health-related quality of life associated with systemic corticosteroids. Qual Life Res 26, 1037–1058 (2017). https://doi.org/10.1007/s11136-016-1435-y

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  • DOI: https://doi.org/10.1007/s11136-016-1435-y

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