Safety and associated costs of glucocorticoid therapy for the treatment of chronic inflammatory diseases

Date of Approval
Application Number
16_146
Technical Summary

The aim of this research is to develop tools that enable clinicians and policy decision makers to balance harms and benefits of glucocorticoids for the treatment of chronic inflammatory diseases. This will be achieved through; 1) description of glucocorticoid toxicity profiles and its predictors; and 2) development of treatment stratification tools for clinical evaluation to accurately identify patients at increased risk of developing toxicity. This research will enable informed personalised adaptation of treatment for patients identified with high risk of toxicity (e.g. earlier dose reduction or use of glucocorticoid-sparing therapies), improvement of clinical guidelines and quality of care and equity in health care provision, ultimately improving long-term patient outcomes.

To estimate toxicity rates and describe toxicity patterns we will expand our phenotyping work to identify patients with common chronic inflammatory diseases and adverse events. The description of common patterns of toxicity, overall and in patients with different underlying diseases and age groups, and the exploration of the relative importance of duration of medication and dose will inform the construction of risk prediction models to enable patient risk stratification according to risk of toxicity development and the future development of decision cost-models to guide policy and clinical decision making.

Health Outcomes to be Measured

Glucocorticoid toxicity All-cause hospitalisation Hospitalisation for toxicity Death for toxicity All-cause mortality

Collaborators

Ann Morgan - Chief Investigator - University of Leeds
Ann Morgan - Corresponding Applicant - University of Leeds
Chris Bojke - Collaborator - University of Leeds
Mar Pujades Rodriguez - Collaborator - University of Leeds
Paul David Baxter - Collaborator - University of Leeds
Paul Stewart - Collaborator - University of Leeds
Richard Hubbard - Collaborator - University of Nottingham
Samantha Crossfield - Collaborator - University of Leeds

Linkages

HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation