One in Six Adults in England Prescribed Corticosteroids in 2023, National Study Finds

Led by researchers from Imperial College London, and working with colleagues from universities across the UK, the study team analysed data from more than 2.5 million patients using the Clinical Practice Research Datalink (CPRD) Aurum, a national database representing around 20% of English GP practices.

The findings, published in Lancet Primary Care, show that corticosteroids, a key treatment for inflammation and immune-related diseases, remain widely and frequently prescribed, raising questions about long-term use and the need for safer alternatives.

The team found that over 12 million corticosteroid prescriptions were issued during 2023, most commonly for respiratory, skin, and joint conditions. Inhaled corticosteroids, used to treat asthma and chronic obstructive pulmonary disease (COPD), accounted for the largest share (44%), followed by topical (20%), nasal (14%) and oral (14%) formulations.

“Corticosteroids are really important medications used to reduce inflammation in many different conditions. They are often among the first treatments prescribed, but we know that their overuse or misuse can lead to side effects or new health problems. We wanted to understand the current landscape of corticosteroid prescribing in England to set the scene before conducting further research to quantify the side effects of corticosteroids and understand which patients may be best suited to other types of medications that are available. Ultimately, this work will help to strengthen prescribing guidelines and improve population health.” said Dr Hannah Whittaker, lead author from Imperial’s School of Public Health. 

The study also found that only about half of all patients prescribed corticosteroids had a clearly recorded clinical indication, such as asthma or eczema, in their medical record. This suggests potential gaps in documentation that could make it harder to review treatment or monitor side effects.

Among those with a recorded indication, asthma was the most common (63%), with eczema (18%) and COPD (17%) following. Many patients had conditions affecting more than one organ system, most often respiratory and dermatological diseases.

Corticosteroids are known to be associated with a range of adverse effects, including weight gain, osteoporosis, and immune suppression, particularly with prolonged use. Given the increasing number of biologic and other targeted treatments now available, the researchers say their findings provide an important baseline for evaluating future changes in steroid prescribing.

“Our findings highlight the need for further research to inform prescribing guidelines and improve monitoring, so that unnecessary exposure to corticosteroids can be reduced and patients receive the safest and most effective treatments,” said Dr Whittaker.

The study was supported by Health Data Research UK as part of the Inflammation and Immunity Driver Programme.

The study, titled “Prescriptions of corticosteroids in primary care in England and related clinical indications: national population-based cohort study,” was conducted by researchers from Imperial College London, the University of Manchester, the University of Nottingham, the University of Dundee, the University of Edinburgh, and others. You can read it here: https://doi.org/10.1016/j.lanprc.2025.100080

Full Citation: 

Whittaker, H. R., Jani, M., Pearce, F. A., Bell, S., Kallis, C., Hawcutt, D., Brown, S., Neves, A. L., Robson, J., Shi, T., Lax, S. J., Sheikh, A., & Quint, J. K. (2025). Prescriptions of corticosteroids in primary care and related clinical indications: A national population-based cohort study in England. The Lancet Primary Care, 1(6), 100080. https://doi.org/10.1016/j.lanprc.2025.100080