Lai, Chih-ChengChih-ChengLaiChen, Chao-HsienChao-HsienChenWang, Ya-HuiYa-HuiWangWang, Cheng-YiCheng-YiWangHAO-CHIEN WANG2025-05-142025-05-142025-04https://scholars.lib.ntu.edu.tw/handle/123456789/729286Background: Asthma patients requiring oral corticosteroids (OCS) are at increased risk of adverse effects. Research focusing on asthma patients adhering to guideline-directed therapy remains limited. This study evaluates the adverse effects of corticosteroids in asthma patients treated with high-dose inhaled corticosteroids (ICS) who required additional OCS due to inadequate disease control. Research design and methods: We conducted a retrospective cohort study of asthma patients from Taiwan’s asthma pay-for-performance program, who had used high-dose ICS for at least 90 days, categorizing them based on OCS use. In the short-term period (3 months), patients were classified into a control group (no OCS) and an OCS group (≥450 mg OCS within 90 days). In the long-term period (6 months), the OCS group consisted of patients receiving ≥ 900 mg OCS within 180 days. Results: A total of 173,835 patients were enrolled for analysis. We assessed the risks of osteoporosis, diabetes, hypertension, infections, cardiovascular diseases, mental health disorders, and ocular conditions. Both short- and long-term OCS users exhibited significantly higher risks of these adverse outcomes compared to the control group. Conclusions: These findings highlight the substantial health risks associated with OCS. Clinicians should carefully consider alternative strategies to minimize harm while ensuring effective disease control.enAsthmaadverse eventsoral corticosteroidssevere asthmasteroid-dependent asthmajournal article10.1080/17512433.2025.247083439998895