PMID- 22018191
OWN - NLM
STAT- MEDLINE
DCOM- 20111221
LR  - 20170112
IS  - 0392-856X (Print)
IS  - 0392-856X (Linking)
VI  - 29
IP  - 5 Suppl 68
DP  - 2011 Sep-Oct
TI  - Adverse events of intravenous glucocorticoid pulse therapy in inflammatory 
      diseases: a meta-analysis.
PG  - S85-92
AB  - OBJECTIVES: To systematically analyse the literature on reported adverse events 
      (AEs) of intravenous pulse glucocorticoids (GCs) (>/= 250 mg prednisone equivalent) 
      for inflammatory diseases. METHODS: A literature search was done using PubMed, 
      Embase, and Cochrane databases. Studies were selected by two reviewers (NAMS and 
      ND). Available data on the prevalence of GC-related AEs in patients with 
      inflammatory diseases were retrieved. RESULTS: In only 8 studies (344 patients), 
      4 placebo-controlled and 4 not placebo-controlled studies, intravenous pulse 
      GC-related AEs had been documented (in total 323 AEs), with an AE rate of 35/100 
      patient-years. In the 4 placebo-controlled studies among RA and systemic 
      sclerosis patients, most of the odds ratios of individual AEs were not 
      statistically significant, except for flushing, heart rhythm disorder, 
      disturbance of taste, lower respiratory infection, and headache. In the 4 not 
      placebo-controlled studies increased diastolic blood pressure was most frequent, 
      followed by flushing and diabetes mellitus. Adverse events seen in more than 15% 
      of patients of all included studies were increased blood pressure, flushing, 
      headache, disturbance of taste, tachycardia and hyperglycemia. CONCLUSIONS: GC 
      pulse therapy results in a high AE rate, i.e. 35/100 patient-years. 
      Cardiovascular AEs are most frequently reported in the literature. Furthermore, 
      flushing had the highest odds ratio in the placebo-controlled studies and also a 
      high event rate in the not placebo-controlled studies.
FAU - Smits, N A M
AU  - Smits NA
AD  - Department of Rheumatology & Clinical Immunology, University Medical Center 
      Utrecht, Utrecht, The Netherlands. n.a.m.smits@students.uu.nl
FAU - Duru, N
AU  - Duru N
FAU - Bijlsma, J W J
AU  - Bijlsma JW
FAU - Jacobs, J W G
AU  - Jacobs JW
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20111021
PL  - Italy
TA  - Clin Exp Rheumatol
JT  - Clinical and experimental rheumatology
JID - 8308521
RN  - 0 (Glucocorticoids)
SB  - IM
MH  - Glucocorticoids/*administration & dosage/*adverse effects
MH  - Humans
MH  - Inflammation/*drug therapy
MH  - Injections, Intravenous/adverse effects
MH  - Pulse Therapy, Drug/adverse effects
MH  - Review Literature as Topic
MH  - Rheumatic Diseases/*drug therapy
EDAT- 2011/11/11 06:00
MHDA- 2011/12/22 06:00
CRDT- 2011/10/25 06:00
PHST- 2011/07/29 00:00 [received]
PHST- 2011/09/14 00:00 [accepted]
PHST- 2011/10/25 06:00 [entrez]
PHST- 2011/11/11 06:00 [pubmed]
PHST- 2011/12/22 06:00 [medline]
AID - 5278 [pii]
PST - ppublish
SO  - Clin Exp Rheumatol. 2011 Sep-Oct;29(5 Suppl 68):S85-92. Epub 2011 Oct 21.