Essential Site Maintenance: Authorea-powered sites will be updated circa 15:00-17:00 Eastern on Tuesday 5 November.
There should be no interruption to normal services, but please contact us at [email protected] in case you face any issues.

loading page

Outpatient Inhaled Corticosteroid Use in Bronchopulmonary Dysplasia
  • +5
  • Sharon McGrath-Morrow,
  • Cynara Leon,
  • Amanda Martin,
  • Lisa Young,
  • Brianna C. Aoyama,
  • Jessica Rice,
  • Jelte Kelchtermans,
  • Joseph Collaco
Sharon McGrath-Morrow
The Children's Hospital of Philadelphia

Corresponding Author:[email protected]

Author Profile
Cynara Leon
The Children's Hospital of Philadelphia
Author Profile
Amanda Martin
The Children's Hospital of Philadelphia
Author Profile
Lisa Young
The Children's Hospital of Philadelphia
Author Profile
Brianna C. Aoyama
The Johns Hopkins University School of Medicine
Author Profile
Jessica Rice
The Children's Hospital of Philadelphia
Author Profile
Jelte Kelchtermans
The Children's Hospital of Philadelphia
Author Profile
Joseph Collaco
The Johns Hopkins University School of Medicine
Author Profile

Abstract

Rationale: In the outpatient setting, inhaled corticosteroids (ICS) are frequently given to children with bronchopulmonary dysplasia (BPD) for treatment of respiratory and asthma associated symptoms. In this study we sought to determine if correlations existed between ICS use and ICS initiation and patient characteristics and outpatient respiratory outcomes. Methods: This study included children with the diagnosis of BPD (n=661) who were seen in outpatient pulmonary clinics at the Children’s Hospital of Philadelphia between 2016-2021. Chart review was used to determine patient demographics, use and timing of ICS initiation, asthma diagnosis and acute care usage following initial hospital discharge. Results: At the first pulmonary visit, 9.2% of children had been prescribed an ICS at NICU discharge, 13.9% had been prescribed an ICS after NICU discharge but before their first pulmonary appointment, and 6.9% were prescribed an ICS at completion of initial pulmonary visit. Children started on an ICS as outpatients, had a higher likelihood of ER visits (adjusted OR: 2.68 ±0.7), hospitalizations (4.81 ± 1.16) and a diagnosis of asthma (3.58 ± 0.84), compared to children never on an ICS. Of those diagnosed with asthma, children prescribed an ICS in the outpatient setting received the diagnosis at an earlier age. No associations between NICU BPD severity scores and ICS use were found. Conclusions: This study identifies an outpatient BPD phenotype associated with ICS use and ICS initiation independent of NICU severity score. Additionally, outpatient ICS initiation correlates with a subsequent diagnosis of asthma and acute care usage in children with BPD.
Submitted to Pediatric Pulmonology
24 Feb 2024Submission Checks Completed
24 Feb 2024Assigned to Editor
02 Apr 2024Editorial Decision: Revise Minor
03 Jun 2024Review(s) Completed, Editorial Evaluation Pending
04 Jun 2024Editorial Decision: Accept