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New research · Gastroenterology
Drug safety · 17h
Cohort studyDrug safety · 2026

Transient Oral Corticosteroid Use and Acute Upper Gastrointestinal Bleeding in Mild-to-Moderate Asthma: A Case-Crossover Study.

Jiaying Li, Pierre Ernst, Samy Suissa
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GastroenterologyCohort study

Short-term oral corticosteroid use not linked to upper gastrointestinal bleeding in mild-to-moderate asthma

Transient Oral Corticosteroid Use and Acute Upper Gastrointestinal Bleeding in Mild-to-Moderate Asthma: A Case-Crossover Study.

Jiaying Li et al. · Drug safety · 2026
Background

Sustained exposure to oral corticosteroids (OCS) increases the risk of upper gastrointestinal bleeding (UGIB).

Purpose

This study aims to estimate the risk of acute UGIB after transient OCS use in patients with mild-to-moderate asthma.

Methods

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.

n = 655,217 patients
Results

slightly higher chance of stomach and gut bleeding, but not a real difference

OR 1.12 (95% CI 0.91 to 1.36)
null = 10.911.36
CI crosses the null - not significant
More results

It is uncertain whether short-term OCS treatment of asthma exacerbations increases this risk.

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.

More results

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.

Higher OCS-related UGIB risk was observed during periods of no inhaled corticosteroid (ICS) use, but not during periods of regular ICS use.

“
Conclusion

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.

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