Corticosteroid-induced adverse events in adults: frequency, screening and prevention.
Corticosteroids represent the most important and frequently used class of anti-inflammatory drugs and are the reference therapy for numerous neoplastic, immunological and allergic diseases. However, their substantial efficacy is often counter-balanced by multiple adverse events. These corticosteroid-induced adverse events represent a broad clinical and biological spectrum from mild irritability to severe and life-threatening adrenal insufficiency or cardiovascular events. The purpose of this article is to provide an overview of the available data regarding the frequency, screening and prevention of the adverse events observed in adults during systemic corticosteroid therapy (topically administered corticosteroids are outside the remit of this review). These include clinical (i.e. adipose tissue redistribution, hypertension, cardiovascular risk, osteoporosis, myopathy, peptic ulcer, adrenal insufficiency, infections, mood disorders, ophthalmological disorders, skin disorders, menstrual disorders, aseptic necrosis, pancreatitis) and biological (i.e. electrolytes homeostasis, diabetogenesis, dyslipidaemia) events. Lastly, data about the prescription of corticosteroids during pregnancy are provided. This review underscores the absence of data on many of these adverse events (e.g. lipodystrophy, dyslipidaemia). Our intent is to present to practitioners data that can be used in a practical way to both screen and prevent most of the adverse events observed during systemic corticosteroid therapy.
Fardet
Laurence
L
Department of Internal Medicine, Hôpital Saint Antoine, Paris, France. laurence.fardet@sat.aphp.fr
Kassar
Abdulrhaman
A
Cabane
Jean
J
Flahault
Antoine
A
D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D050171:Dyslipidemias / Q000209:etiology; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D011247:Pregnancy; D014882:Water-Electrolyte Balance / Q000187:drug effects
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents