top of page

Thirty-year trends analysis reveals continuous overuse of systemic glucocorticoids to treat patients with asthma in the United Kingdom

Singapore, [19 April 2024] – Analysis of data from the Optimum Patient Care Research Database (OPCRD) has shown high rates of systemic glucocorticoid (SGC) prescription for asthma in the United Kingdom (UK), which have persisted despite the availability of alternative steroid-sparing strategies and treatments.


The study, Trends in Systemic Glucocorticoid Utilization in the United Kingdom from 1990 to 2019: A Population-Based, Serial Cross-Sectional Analysis, was conducted by the Observational and Pragmatic Research Institute (OPRI), co-funded by AstraZeneca, and is published in the March issue of Pragmatic and Observational Research. (1)

Relative contribution of conditions of interest (a) to total SGC dose per year

Abbreviations: COPD, chronic obstructive pulmonary disease; SGC, systemic glucocorticoid; SLE, systemic lupus erythematosus.

(a) Other category includes: ankylosing spondylitis, myasthenia gravis, sarcoidosis, uveitis, autoimmune bullous, eczema, nephrotic syndrome, scleritis, vasculitis, autoimmune hepatitis, gout, polymyalgia, Sjogren’s syndrome, Bell’s palsy, iritis, psoriasis, carditis, multiple sclerosis, psoriatic arthropy, and temporal arteritis.


“These are concerning findings”, said Professor David Price, corresponding author, and Director of OPRI. “The numbers of patients with asthma and COPD in the UK are increasing and any SGC exposure, even occasional short-term use, increases patients’ risk of diabetes, osteoporosis, cardiovascular diseases and other health conditions – even death.”


The OPCRD holds electronic medical records from >20 million patients from >1000 UK general practices. For each year from 1990 to 2019, OPRI researchers determined SGC exposure among patients aged 5 years and above who had asthma, COPD, nasal polyps, Crohn’s disease, rheumatoid arthritis, ulcerative colitis, or systemic lupus erythematosus. Asthma was consistently the greatest contributor to SGC utilization; asthma and COPD accounted for more than two-thirds of UK patients prescribed SGCs every year since 1990. The data showed declines in SGC prescriptions for Crohn’s disease, ulcerative colitis, and rheumatoid arthritis since the introduction of biologic therapies, as well as for severe asthma; however, SGC prescriptions for non-severe asthma and for COPD increased. The relative contribution of COPD to the OCS burden approximately doubled over time, while no biologic therapies for COPD were approved during the observation period.


“These results highlight urgent needs to raise awareness about the adverse consequences of SGC use and to adopt alternative steroid-sparing strategies and treatments that can reduce this largely avoidable burden”, said Professor Price.


To learn more about the study, please read the full publication in the Pragmatic and Observational Research as well as the accompanying slide deck below.

Trends in UK SGC Utilization 1990-2019
Download PDF • 1.33MB

The Observational and Pragmatic Research Institute (OPRI) is an independent, internationally recognised research organisation which conducts studies that provide real-world evidence to support best practices for chronic disease management in primary care and make a difference to patients.


For media inquiries and additional information, please contact



(1) Menzies-Gow AN, Tran TN, Stanley B, Carter VA, Smolen JS, Bourdin A, Fitzgerald JM, Raine T, Chapaneri J, Emmanuel B, Jackson DJ, Price DB. Trends in Systemic Glucocorticoid Utilization in the United Kingdom from 1990 to 2019: A Population-Based, Serial Cross-Sectional Analysis. Pragmat Obs Res. 2024;15:53-64.


bottom of page