RESEARCH - Population-based assessment of adverse events associated with long-term steroid use

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Arthritis Rheum. 2006 Jun 15;55(3):420-6.

Population-based assessment of adverse events associated with long-term

glucocorticoid use.

University of Alabama at Birmingham, 35294, USA.

OBJECTIVE: The frequency of many adverse events (AEs) associated with

low-dose glucocorticoid use is unclear. We sought to determine the

prevalence of glucocorticoid-associated AEs in a large US managed care

population. METHODS: Using linked administrative and pharmacy claims, adults

receiving >or=60 days of glucocorticoids were identified. These individuals

were surveyed about glucocorticoid use and symptoms of 8 AEs commonly

attributed to glucocorticoid use. RESULTS: Of the 6,517 eligible

glucocorticoid users identified, 2,446 (38%) returned the mailed survey.

Respondents were 29% men with a mean +/- SD age of 53 +/- 14 years; 79% were

white and 13% were African American. Respondents had a mean +/- SD of 7 +/-

3 comorbid conditions and were prescribed a mean +/- SD

prednisone-equivalent dosage of 16 +/- 14 mg/day. More than 90% of

individuals reported at least 1 AE associated with glucocorticoid use; 55%

reported that at least 1 AE was very bothersome. Weight gain was the most

common self-reported AE (70% of the individuals), cataracts (15%) and

fractures (12%) were among the most serious. After multivariable adjustment,

all AEs demonstrated a strong dose-dependent association with cumulative

glucocorticoid use. Among users of low-dose therapy (<or=7.5 mg of

prednisone per day), increasing duration of use was significantly associated

with acne, skin bruising, weight gain, and cataracts.

CONCLUSION: The prevalence of 8 commonly attributed self-reported

glucocorticoid-associated AEs was significantly associated with cumulative

and average glucocorticoid dose in a dose-dependent fashion. Physicians

should be vigilant for glucocorticoid-related AEs and should counsel

patients about possible risks, even among low-dose long-term users.

PMID: 16739208

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16739208

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