Does Extended Steroid Exposure Increase Adverse Event Incidence?

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The most common adverse events among the high dose group was hypertension, pneumonia, and osteoporosis.
The most common adverse events among the high dose group was hypertension, pneumonia, and osteoporosis.

Extended corticosteroid use can significantly increase the incidence of adverse events (AE) compared to intermittent use, according to new research published in the journal Current Medical Research and Opinion

Using a privately-insured administrative database, the researchers examined patients a total of 78,704 patients with autoimmune or inflammatory disease diagnoses between 2066 and 2015. They were categorized by usage: intermittent use with duration <60 days, and extended use with a duration of ≥60 days and dosage of ≤7.5 mg/day, >7.5-≤15 mg/day, or >15 mg/day prednisone-equivalent.

Of the 78,704 patients 9.5%, 11.0%, and 8.6% were classified as high-, medium, and low dose extended corticosteroid users, respectively. The most common AEs among the high dose group was hypertension, pneumonia, and osteoporosis which had high incidence rates of 41.9, 27.4 and 19.8 per 1000 patient-months, respectively.

The authors noted that, 'For most adverse events, all levels of corticosteroid use exhibited significant risks of increased incidence compared to intermittent use.' Adverse events occurred at a mean of 2.3-6.7 months after initiation, a relatively short period. Also, dose-relationships and duration-relationships were identified with some AEs. 

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