PMID- 28357813
OWN - NLM
STAT- MEDLINE
DCOM- 20171024
LR  - 20220409
IS  - 1179-1918 (Electronic)
IS  - 1173-2563 (Linking)
VI  - 37
IP  - 6
DP  - 2017 Jun
TI  - Rate of Adverse Effects of Medium- to High-Dose Glucocorticoid Therapy in 
      Systemic Lupus Erythematosus: A Systematic Review of Randomized Control Trials.
PG  - 519-524
LID - 10.1007/s40261-017-0518-z [doi]
AB  - BACKGROUND AND OBJECTIVES: The efficacy of glucocorticoids (GCs) in treating 
      systemic lupus erythematosus (SLE) is beyond doubt. However, GCs-related adverse 
      effects (AEs) are multiple and serious. Despite the current available evidence 
      suggesting to reduce daily doses of prednisone <7.5 mg/day, or even to withdraw 
      it, in the real-life practice, it is not uncommon to see patients receiving 
      medium doses (up to 30 mg/day prednisone or equivalent) or high doses 
      (>/=30 mg/day). METHODS: We systematically reviewed the literature with a priori 
      strategy, to assess the rate of AEs related to medium or high doses of GCs in 
      patients with SLE, analyzing randomized control trials with at least one of the 
      treatment groups including GCs alone at medium or high doses. RESULTS: We found a 
      rate of 9/100 patients/year for hyperglycemias/diabetes, 25/100 patients/year 
      for infections, and 12/100 patients/year for avascular necrosis of the hip. 
      Interestingly, when adjusting for GC dose and treatment duration, we observed no 
      difference in terms of AEs comparing patients receiving medium versus high doses. 
      CONCLUSIONS: In the era when treat-to-target strategies have been proposed in 
      order to control SLE disease activity, improved health-related quality of life, 
      and reduced morbidity and mortality, using GCs in a more restrictive way should 
      be a goal to prevent major complications in patients with SLE.
FAU - Sciascia, Savino
AU  - Sciascia S
AD  - Center of Research of Immunopathology and Rare Diseases, Coordinating Center of 
      Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and 
      Biological Sciences, S. Giovanni Bosco Hospital and University of Turin, Piazza 
      del Donatore di Sangue 3, 10154, Turin, Italy. savino.sciascia@unito.it.
AD  - SCDU Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. 
      Giovanni Bosco Hospital, Turin, Italy. savino.sciascia@unito.it.
FAU - Mompean, Elisa
AU  - Mompean E
AD  - Louise Coote Lupus Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK.
FAU - Radin, Massimo
AU  - Radin M
AD  - Center of Research of Immunopathology and Rare Diseases, Coordinating Center of 
      Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and 
      Biological Sciences, S. Giovanni Bosco Hospital and University of Turin, Piazza 
      del Donatore di Sangue 3, 10154, Turin, Italy.
FAU - Roccatello, Dario
AU  - Roccatello D
AD  - Center of Research of Immunopathology and Rare Diseases, Coordinating Center of 
      Piemonte and Valle d'Aosta Network for Rare Diseases, Department of Clinical and 
      Biological Sciences, S. Giovanni Bosco Hospital and University of Turin, Piazza 
      del Donatore di Sangue 3, 10154, Turin, Italy.
AD  - SCDU Nephrology and Dialysis, Department of Clinical and Biological Sciences, S. 
      Giovanni Bosco Hospital, Turin, Italy.
FAU - Cuadrado, Maria J
AU  - Cuadrado MJ
AD  - Louise Coote Lupus Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - New Zealand
TA  - Clin Drug Investig
JT  - Clinical drug investigation
JID - 9504817
RN  - 0 (Glucocorticoids)
SB  - IM
MH  - Glucocorticoids/*adverse effects
MH  - Humans
MH  - Hyperglycemia/chemically induced
MH  - Lupus Erythematosus, Systemic/*drug therapy/psychology
MH  - Quality of Life
MH  - Randomized Controlled Trials as Topic
EDAT- 2017/03/31 06:00
MHDA- 2017/10/25 06:00
CRDT- 2017/03/31 06:00
PHST- 2017/03/31 06:00 [pubmed]
PHST- 2017/10/25 06:00 [medline]
PHST- 2017/03/31 06:00 [entrez]
AID - 10.1007/s40261-017-0518-z [pii]
AID - 10.1007/s40261-017-0518-z [doi]
PST - ppublish
SO  - Clin Drug Investig. 2017 Jun;37(6):519-524. doi: 10.1007/s40261-017-0518-z.