REVIEW - The epidemiology of steroid-associated adverse events

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Current Opinion in Rheumatology. 20(2):131-137, March 2008.

Epidemiology and health-related services

McDonough, Allyson K; Curtis, R; Saag, G

The epidemiology of glucocorticoid-associated adverse events.

Abstract:

Purpose of review: The introduction of glucocorticoid therapy by Dr

Philip Hench in the 1950s revolutionized the treatment of rheumatic

and inflammatory disease. These preparations remain an important

component of therapy for a variety of diseases. As with any potent

medication, however, they are not without side effects. Analysis of

physician understanding and practice suggest that appreciation for the

frequency and significant morbidity associated with glucocorticoids is

poor. The purpose of this review is to provide an update on the most

recent literature regarding glucocorticoid use and associated adverse

events.

Recent findings: Recent studies suggest that adverse events such as

weight gain, skin thinning, sleep disturbance and neuropsychiatric

disorders may occur in patients taking glucocorticoids. Adverse events

may occur even in low-dose therapy and appear to be dose and duration

dependent. Glucocorticoid-induced osteoporosis is a potentially

preventable complication but physician adherence to preventive

guidelines is poor. New data reinforce the understanding that

glucocorticoids significantly increase the risk of infection. There

are strong data-driven concerns about the increased susceptibility of

children and possibly even neonates to glucocorticoid-associated

adverse events.

Summary: Glucocorticoid therapy, while important in the treatment of a

variety of serious inflammatory diseases, causes significant morbidity

among long term users.

http://www.co-rheumatology.com/pt/re/corheum/abstract.00002281-200803000-00004.h\

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