PMID- 16739208
OWN - NLM
STAT- MEDLINE
DCOM- 20060706
LR  - 20220331
IS  - 0004-3591 (Print)
IS  - 0004-3591 (Linking)
VI  - 55
IP  - 3
DP  - 2006 Jun 15
TI  - Population-based assessment of adverse events associated with long-term 
      glucocorticoid use.
PG  - 420-6
AB  - 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.
FAU - Curtis, Jeffrey R
AU  - Curtis JR
AD  - University of Alabama at Birmingham, 35294, USA.
FAU - Westfall, Andrew O
AU  - Westfall AO
FAU - Allison, Jeroan
AU  - Allison J
FAU - Bijlsma, Johannes W
AU  - Bijlsma JW
FAU - Freeman, Allison
AU  - Freeman A
FAU - George, Varghese
AU  - George V
FAU - Kovac, Stacey H
AU  - Kovac SH
FAU - Spettell, Claire M
AU  - Spettell CM
FAU - Saag, Kenneth G
AU  - Saag KG
LA  - eng
GR  - HS10389/HS/AHRQ HHS/United States
GR  - P60-AR-48095/AR/NIAMS NIH HHS/United States
GR  - T32-AR-47512-03/AR/NIAMS NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Arthritis Rheum
JT  - Arthritis and rheumatism
JID - 0370605
RN  - 0 (Glucocorticoids)
SB  - IM
MH  - Administration, Oral
MH  - Cataract/chemically induced/*epidemiology
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Fractures, Spontaneous/chemically induced/*epidemiology
MH  - Glucocorticoids/*adverse effects
MH  - Humans
MH  - Iatrogenic Disease/*epidemiology
MH  - Male
MH  - Managed Care Programs
MH  - Middle Aged
MH  - *Population Surveillance
MH  - Prevalence
MH  - Surveys and Questionnaires
MH  - United States/epidemiology
EDAT- 2006/06/02 09:00
MHDA- 2006/07/11 09:00
CRDT- 2006/06/02 09:00
PHST- 2006/06/02 09:00 [pubmed]
PHST- 2006/07/11 09:00 [medline]
PHST- 2006/06/02 09:00 [entrez]
AID - 10.1002/art.21984 [doi]
PST - ppublish
SO  - Arthritis Rheum. 2006 Jun 15;55(3):420-6. doi: 10.1002/art.21984.