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Short-term corticosteroid use associated with increased risk of adverse events

Study aimed to determine the frequency of serious adverse events associated with corticosteroid use – specifically sepsis, VTE and fracture

Study aims to determine the frequency of serious adverse events associated with corticosteroid use – specifically sepsis, VTE and fracture


Short-term use of corticosteroids increased the incidence of adverse events. Picture: iStock

Corticosteroids are powerful anti-inflammatory drugs that have been used to treat a variety of diseases since their introduction for rheumatoid arthritis in 1949. A strong driver for corticosteroid use is their symptomatic relief.

Long-term use is generally avoided, because of serious acute complications such as infection, venous thromboembolism (VTE) and fracture as well as chronic diseases such as diabetes mellitus, hypertension and osteoporosis. Adverse events as a result of corticosteroids are one of the most common reasons for admission to hospital.

In contrast with long-term use, the risk from short-term use is much less understood. Brief courses are often used to treat inflammatory conditions such as asthma, inflammatory bowel disease, rheumatoid arthritis and chronic obstructive pulmonary disease, as well as conditions for which the indication is less clear including upper respiratory tract infection, spinal conditions, non-specific muscle pain and allergies.

Increase

This study aimed to determine the frequency of serious adverse events associated with corticosteroid use – specifically sepsis, VTE and fracture. Researchers looked only at short-term use defined as less than 30 days. Of 1,548,945 adults, 21% (327,452) had been given a prescription for short-term use of corticosteroids over the three-year study period. The results show that, within 30 days of starting the drug, the incidence of adverse events increased by between twofold and fivefold.

The authors conclude that prescribing these drugs with more care and monitoring adverse events when they are used, could improve patient safety.


Waljee A, Rogers M, Lin P et al (2017) Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ. 357:j1415. doi:10.1136/bmj.j1415

 

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