Adverse events of low- to medium-dose oral glucocorticoids in inflammatory diseases: a meta-analysis
Objectives:To systematically analyse the literature on reported adverse events of low- to medium-dose glucocorticoids during ⩾1 month for inflammatory diseases.Methods:Data were systematically retrieved and selected from PUBMED, EMBASE and CINAHL databases (6097 hits).Results:A total of 28 studies (...
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Published in | Annals of the rheumatic diseases Vol. 68; no. 12; pp. 1833 - 1838 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
London
BMJ Publishing Group Ltd and European League Against Rheumatism
01.12.2009
BMJ Publishing Group BMJ Publishing Group LTD |
Subjects | |
Online Access | Get full text |
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Summary: | Objectives:To systematically analyse the literature on reported adverse events of low- to medium-dose glucocorticoids during ⩾1 month for inflammatory diseases.Methods:Data were systematically retrieved and selected from PUBMED, EMBASE and CINAHL databases (6097 hits).Results:A total of 28 studies (2382 patients) met the inclusion criteria. The risk of adverse events over all studies was 150 per 100 patient-years (95% confidence interval (CI) 132 to 169). Psychological and behavioural adverse events (eg, minor mood disturbances) were most frequently reported, followed by gastrointestinal events (eg, dyspepsia, dysphagia). In 14 studies comprising 796 patients with rheumatoid arthritis the risk of adverse events was 43/100 patient-years (95% CI 30 to 55), in 4 studies of 167 patients with polymyalgia rheumatica the risk of adverse events was 80/100 patient-years (95% CI 15 to146), and in 10 studies of 1419 patients with inflammatory bowel disease the risk of adverse events was 555/100 patient-years (95% CI 391 to 718). High rates of adverse events were reported in high-quality studies with short follow-up, notably in studies of patients with inflammatory bowel disease.Conclusions:The risk of adverse events depends on study design and disease. Studies on inflammatory bowel disease were often of short duration with frequent documentation of adverse events which resulted in higher adverse event rates whereas, in studies of rheumatoid arthritis, the longer follow-up may have resulted in lower adverse event rates. In most studies aimed at efficacy of glucocorticoids or other drugs, adverse events were not systematically assessed. Clear guidelines on assessment of adverse events are lacking. |
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Bibliography: | Extended report istex:3A4910A1D5269CCF34A59B81D06C303677C5A674 ArticleID:ar100008 href:annrheumdis-68-1833.pdf local:annrheumdis;68/12/1833 PMID:19066177 Appendices 1 and 2 are published online only at http://ard.bmj.com/content/vol68/issue12 ark:/67375/NVC-7621M1QK-Q |
ISSN: | 0003-4967 1468-2060 |
DOI: | 10.1136/ard.2008.100008 |