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Rheumatology (Oxford). 2011 Nov;50(11):1982-90. doi: 10.1093/rheumatology/ker017. Epub 2011 Mar 10.

Prevalence of long-term oral glucocorticoid prescriptions in the UK over the past 20 years.

Author information

  • 1MRC General Practice Research Framework, University College London Medical School, Stephenson House, 158-160 North Gower Street, London NW1 2ND, UK. laurence.fardet@sat.aphp.fr

Abstract

OBJECTIVE:

To assess trends in long-term (i.e. ≥3 months) oral glucocorticoid (GC) prescriptions over the past 20 years.

METHODS:

Data of UK adult patients registered between January 1989 and December 2008 with general practices contributing to The Health Improvement Network (THIN) database were obtained. The annual prevalence of long-term oral GC prescriptions was assessed in the whole population and specifically in people with RA, PMR/GCA, asthma, chronic obstructive pulmonary disease (COPD), Crohn's disease and ulcerative colitis (UC). Trends over the 20-year period were estimated using sex- and age-adjusted Poisson regression models.

RESULTS:

During the 26 035 154 person-years of follow-up, an average of 0.75% (95% CI 0.74, 0.75) of the study population was prescribed long-term oral GC therapy at any time point. This rose from 0.59% (0.52, 0.67) in 1989 to 0.79% (0.78, 0.80) in 2008. Long-term prescriptions significantly increased in patients with RA [from 10.3% (8.7, 11.9) to 13.6% (12.9, 14.2)] and PMR/GCA [from 57.6% (53.3, 62.0) to 66.5% (65.2, 67.7)], decreased in patients with asthma, COPD and Crohn's disease and remained stable in patients with UC. However, when only incident cases were considered, we found a decreased use of GCs in patients with RA and UC [odds ratio 0.97 (95% CI 0.96, 0.97) and 0.94 (95% CI 0.93, 0.96) per increasing year, respectively].

CONCLUSION:

Over the past 20 years, long-term oral GC prescriptions have increased by 34%. Patients newly diagnosed with RA, Crohn's disease or UC are, however, less likely to receive long-term GC prescriptions than patients with a long past medical history of the disease, suggesting changes in physicians' practice.

Comment in

  • Glucocorticoids are forever? [Rheumatology (Oxford). 2011]
PMID:
21393338
[PubMed - indexed for MEDLINE]
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