OCS use
A total number of 47,389 individuals (14.9%) became OCS users during the study period, whereof 4,475 (1.4% of the total cohort) at one point fulfilled the criteria of having a high OCS use corresponding to ≥5 mg OCS/day within a calendar year. The annual prevalence of OCS users was 4.8% (median, IQR 4.7%-4.8%) with a slight increase from 4.3% in 1999 to 4.7% in 2018. The prevalence of high-users decreased from 0.54% in 1999 to 0.33% in 2018 (Figure 2A ). OCS use was more prevalent among women and in older age groups, as depicted in Figure 2B and C . The majority (56%) of OCS users was one-time users, while 27% filled 2-3 OCS prescriptions and 16% filled ≥4 prescriptions during their follow up time. The most frequent accumulated dose of OCS was 201-300 mg (32% of all users), while 21% of the users were exposed to >1000 mg during the observation period (Online Supplement Table E3 ). Both the median and mean annual OCS dose among users decreased in the period 1999-2018 from 500 mg/y (IQR 250-750 mg/y) to 250 mg/y (IQR 250-500 mg/y), and from 878 mg/y (SD 1479 mg/y) to 614 mg/y (SD 961 mg/y), respectively (Figure 3 ). The differences in median and mean illustrates a skewness in the distribution of OCS use.