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Creating a Concept Set for Systemic Corticosteroid Indications

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(Torunn Sivesind) #1

I am seeking to identify all potential indications for systemic corticosteroids and was thinking of trying to build a concept set that includes these. I haven’t seen anything similar, but does anyone know if this already exists? I’d appreciate any input.


(Christian Reich) #2

@tsivesind:

You picked the worst drug class. Half of ICD10 can be treated with it, either directly, or sequelae or other consequences. Some conditions are both indication and contraindication (e.g. Covid-19).

What are you trying to do?


(Torunn Sivesind) #3

@Christian_Reich yes it is. We are trying to capture systemic steroids (i.e., not topical formulations) used for the treatment of atopic dermatitis.


(Christian Reich) #4

Why not use the Dose Form in RxNorm.


(Chungsoo Kim) #5

Hi, @tsivesind
If you had ATLAS linked with any CDM database, you could see record counts and descendant record counts. If your study will be doing in your site-specific, you can check the concepts manually and fit your intended.
However, if you want to perform multi-site analysis, as @Christian_Reich mentioned, you have to include all concepts in the world, you would better use the concept hierarchy. All corticosteroids except topical or focal formulation of corticosteroids.
To my knowledge, RxNorm has no classification top concept like “corticosteroids” including all ingredients but the ATC hierarchy has it. so If you don’t have all the ingredient concepts of steroids, maybe you can use the ATC hierarchy also for picking all ingredients.


(Torunn Sivesind) #6

Thanks for the advice @Chungsoo_Kim and @Christian_Reich. This is intended to be a multi-site study, so I believe using the ATC hierarchy to pick all ingredients makes the most sense. I appreciate your help!


(Christian Reich) #7

@tsivesind:

Be careful with ATC. They tend not to always include all attributes. For example, there is 21605164 (S02B) “CORTICOSTERIODS”. But if you look into the hierarchy they are all otologicals. For systemic, you want to try 21602728 (H02AB) “Glucocorticoids” and * 21602746 (H02BX) “Corticosteroids for systemic use, combinations” and their children.

Or better, you pick all Clinical Drug Forms that combine glucocorticosteriods with systemic Dose forms:

concept_id Ingredient name
1115572 beclomethasone
920458 betamethasone
939259 budesonide
902938 ciclesonide
19050907 cloprednol
1507705 cortisone
19061907 cortivazol
19086888 deflazacort
1518254 dexamethasone
1196514 flunisolide
996541 fluocinolone
955252 fluocinonide
19055344 fluocortolone
955583 fluorometholone
1149380 fluticasone
975125 hydrocortisone
19009116 meprednisone
1506270 methylprednisolone
905233 mometasone
19027186 paramethasone
1550557 prednisolone
1551099 prednisone
19011127 prednylidene
977421 rimexolone
19078460 tixocortol
903963 triamcinolone
concept_id Dose Form name
46234466 Auto-Injector
19082103 Injectable Solution
19082104 Injectable Suspension
46234469 Injection
46275062 Jet Injector
46234467 Pen Injector
19126920 Prefilled Syringe

(Torunn Sivesind) #8

Thank you very much @Christian_Reich! That is very helpful.


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