Even Low Steroid Doses Can Be Trouble

[Guest guest]

Even Low Steroid Doses Can Be TroubleFractures tied to common arthritis, asthma drugBy McNamee NeenanHealthScout ReporterMONDAY, Oct. 23 (HealthScout) -- Daily low doses of a commonly prescribedoral steroid, prednisone, can double your risk of hip fractures andcataracts, scientists reported today. Researchers have long known of thelink between higher doses of oral steroids and dangerous side effects, butthe new study shows the potential for side effects at much lower doses, saysDr. B. Wong, an associate professor of medicine at Tufts-New EnglandMedical Center in Boston.The problem is that prednisone and other steroid medications are critical inmanaging diseases in which inflammation plays a painful role, Wong says."Low-dose steroids are used commonly in a number of diseases, includingpatients with asthma or rheumatoid arthritis," he says. Prednisone also isused to treat Crohn's disease and other inflammatory bowel disorders.Wong stresses that people who are taking this medicine should not stop doingso based just on these new findings."If patients are worried about the long-term side effects, I'd encouragethem to discuss it with their doctors," Wong says. "The benefits of themedicine might clearly outweigh the risks."The study tracked the progress of 4,993 people with rheumatoid arthritis for15 years, monitoring their medications and subsequent health.Those who'd taken 5 milligrams to 10 milligrams of prednisone a day weretwice as likely to break their hips and 2½ times as likely to developcataracts as those who had taken no prednisone, the study says.And those who'd taken the steroid at these low doses for three or more yearswere 3.2 times as likely to develop cataracts as those who had not takenprednisone, it says. Findings are being presented today in San Francisco ata meeting of the American College of Chest Physicians.People with rheumatoid arthritis take prednisone orally, while people withasthma usually inhale the medication. But Wong says other tests have shownthat the body absorbs the two forms of medicine similarly.Prednisone is so commonly used that more than half of the participants inthe study used the medication at one point or another, Wong says.However, Dr. Jefrey Lieberman, director of the Arthritis Care Center inAtlanta, says the drug is used less frequently today than it was when Wong'sstudy started in 1982. Lieberman estimates that just 10 percent of hispatients use the drug at any one time.The side effects of prednisone at higher doses have been known for sometime, he says. So, while the medication was first seen as a miracle cure,today it's prescribed with more caution, Lieberman says.About 2.1 million people in the United States are diagnosed with rheumatoidarthritis.Prednisone doesn't affect the progress of the disease, "but nothing worksbetter to reduce inflammation quickly than prednisone," Lieberman says.Doctors constantly are attempting to determine the "magic dose," or how manymilligrams of the medication best help someone without bringing on sideeffects, he says.Attempts to reach Schein Pharmaceuticals, which manufactures Prednisone,were unsuccessful.What to DoLieberman says other oral steroids could be presumed to affect your hips andeyes as prednisone did in this study. These steroids, calledcorticosteroids, differ from anabolic steroids, which bodybuilders sometimesuse to pack on muscle power.If you and your doctor determine that prednisone or another oral steroid isuseful for your health, despite its side effects, your doctor will want tomonitor you closely, Wong says. In keeping an eye on the health of yourbones, for example, and to prevent osteoporosis, your doctor will want tomake sure you have enough vitamin D and calcium in your diet. Ifosteoporosis begins to develop, your doctor may prescribe hormonereplacement therapy or another medication to beef up your bones.Similarly, to protect against cataract formation, your doctor may recommendyou shield your eyes from ultraviolet light exposure as much as possible,usually by wearing sunglasses.http://www.cushings-help.com/prednisone-danger.htm