The cumulative burden of oral corticosteroid side effects and the economic implications of steroid use.
Oral corticosteroids (OCS) are a key part of therapy regimens for a diverse variety of conditions. Despite their efficacy, they are associated with a wide variety of adverse events. The purpose of this review was to identify the range of adverse events that have been reported to be related to oral corticosteroids, examine the factors that influence their incidence and estimate the economic burden caused by these adverse events. In 61 identified studies, 21 different categories of OCS related adverse events were reported with increased fracture risk being the category most frequently described. Most studies that examined factors linked to the incidence of OCS related adverse events found that dose, age, gender, duration of use, treatment history, smoking habits or cholesterol level were influential in determining risk. Additionally, a cumulative economic analysis of selected adverse events found the annual cost of treating these events in the UK to be at least 165 pounds per patient taking OCS. The clinical and economic burden of OCS related adverse events highlights the need for OCS sparing therapies to be developed.
Manson
Stephanie C
SC
United BioSource Corporation, 20 Bloomsbury Square, London WCIA 2NS, UK. stephanie.manson@unitedbiosource.com
Brown
Ruth E
RE
Cerulli
Annamaria
A
Vidaurre
Carlos Fernandez
CF
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects* / Q000191:economics; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000191:economics; D001249:Asthma / Q000188:drug therapy* / Q000191:economics; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000191:economics
D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents