Authors
Jiaying Li, Pierre Ernst, Samy Suissa
Published in
Drug safety. Jul 23, 2026. Epub Jul 23, 2026.
Abstract
Sustained exposure to oral corticosteroids (OCS) increases the risk of upper gastrointestinal bleeding (UGIB). It is uncertain whether short-term OCS treatment of asthma exacerbations increases this risk. This study aims to estimate the risk of acute UGIB after transient OCS use in patients with mild-to-moderate asthma.
We used a case-crossover design within a cohort of patients with mild-to-moderate asthma, aged 18-40 years during 2000-2023, from the UK's Clinical Practice Research Datalink. Subjects who experienced a first severe UGIB formed the case series. Short-term OCS was defined by a prescription for ≤ 14 days, with a 30-day residual effect period. For each case, the UGIB event date and 6 control dates, selected at 45-day intervals in the prior year, were considered exposed if the prescription spanned the date. The odds ratio (OR) of UGIB was estimated using conditional logistic regression, adjusted for time-varying use of asthma inhalers and medications related to bleeding risks. Findings The cohort involved 655,217 patients with mild-to-moderate asthma, with 743 experiencing a first UGIB who received 1160 OCS prescriptions in the past year. The crude and adjusted ORs of UGIB after OCS use versus non-use was 1.12 (95% confidence interval [CI]: 0.92-1.37), and 1.12 (95% CI: 0.91-1.36), respectively. Higher OCS-related UGIB risk was observed during periods of no inhaled corticosteroid (ICS) use, but not during periods of regular ICS use.
Short-term OCS use does not increase UGIB risk in patients with mild-to-moderate asthma. There may be interaction between OCS and ICS in affecting UGIB risk in this patient population.
PMID:
42489820
Bibliographic data and abstract were imported from PubMed on 23 Jul 2026.
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