title: The prediction and monitoring of toxicity associated with long-term systemic glucocorticoid therapy.
abstract: Glucocorticoids are often required for adequate control of inflammation in many serious inflammatory diseases; common indications for long-term treatment include polymyalgia rheumatica, giant cell arteritis, asthma and chronic obstructive pulmonary disease. Long-term glucocorticoid therapy is, however, associated with many adverse effects involving skin, gastro-intestinal, eye, skeletal muscle, bone, adrenal, cardio-metabolic and neuropsychiatric systems. This balance between benefits and risks of glucocorticoids is important for clinical practice and glucocorticoid-related adverse effects can significantly impair health-related quality of life. Understanding the nature and mechanisms of glucocorticoid-related adverse effects may inform how patients are monitored for toxicity and identify those groups, such as older people, that may need closer monitoring. For clinical trials in diseases commonly treated with glucocorticoids, standardised measurement of glucocorticoid-related adverse effects would facilitate future evidence synthesis and meta-analysis.
authors.affiliation: Leeds Institute of Rheumatic and Musculoskeletal Medicine, St James's University Hospital, University of Leeds, Wellcome Trust Brenner Building, Leeds, LS9 7TF, UK, e.z.harris@leeds.ac.uk.
authors.forename: Emma
authors.initials: E
authors.lastname: Harris
authors.forename: Ana
authors.initials: A
authors.lastname: Tiganescu
authors.forename: Sandy
authors.initials: S
authors.lastname: Tubeuf
authors.forename: Sarah Louise
authors.initials: SL
authors.lastname: Mackie
mesh_terms: D003875:Drug Eruptions / Q000209:etiology; D016903:Drug Monitoring / Q000379:methods; D005128:Eye Diseases / Q000139:chemically induced; D013700:Giant Cell Arteritis / Q000188:drug therapy*; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D009135:Muscular Diseases / Q000139:chemically induced; D010024:Osteoporosis / Q000139:chemically induced; D011111:Polymyalgia Rheumatica / Q000188:drug therapy*; D011788:Quality of Life; D013276:Stomach Ulcer / Q000139:chemically induced; D014945:Wound Healing / Q000187:drug effects
chemical_list: D005938:Glucocorticoids