Has OCS use for severe asthma in the US decreased in the last 10 years?

<bold>Background:</bold> Minimising oral corticosteroids (OCS) use has been a recent focus of asthma management. Limited data are available on how usage trends have evolved. <bold>Aim:</bold> Assess OCS use for severe asthma over time. <bold>Methods:</bold> A cross-sectional study using Optum Clinformatics Data Mart. Eligible patients were identified annually, with continuous healthcare claims enrolment each year (Jan 1, 2012–Dec 31, 2022), aged ≥6 years with ≥1 diagnostic claim for asthma, focusing on patients with severe asthma at Global Initiative for Asthma Steps 4–5. Descriptive analysis was performed on asthma-related (within 14 days of a diagnosis code) maintenance OCS (mOCS) and burst OCS use, defined by prescription supply (>28 days for mOCS; ≥3 but ≤28 days for burst OCS). <bold>Results:</bold> The number of patients with severe asthma ranged from 84,282 in 2012 to 136,441 in 2022. The proportion of patients with asthma-related mOCS/burst OCS use declined from 2012 to 2022 (Figure). Mean daily dose for mOCS decreased (15.7 to 12.6 mg); mean cumulative days on mOCS increased (93.9 to 123.5). Mean daily dose for burst OCS remained stable (31.1 to 31.6 mg); cumulative days on burst OCS decreased (14.2 to 13.6). <bold>Conclusions:</bold> mOCS use accounted for a small and slowly decreasing proportion of patients with severe asthma. OCS bursts remained high, despite a decrease coinciding with the COVID pandemic, and should be the primary focus for addressing overall OCS burden. <bold>Funding:</bold> GSK (222443) <fig><object-id>erj;64/suppl_68/PA1175/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>