The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index.
Dose-related patterns of glucocorticoid-induced side effects
Abstract
Objective To identify patterns of self-reported health problems relating to dose and duration of glucocorticoid intake in unselected patients with rheumatoid arthritis from routine practice. Methods Data from 1066 patients were analysed. The clinical status and drug treatment were reported by the physician, health problems during the past 6 months by the patient using a comprehensive list of symptoms. Patients with ongoing glucocorticoid treatment for more than 6 months and current doses of less than 5, 5-7.5 and over 7.5 mg/day prednisone equivalent were compared with a group without any glucocorticoid treatment for at least 12 months. Results The frequency of self-reported health problems was lowest in the group without glucocorticoid exposition and increased with dosage. Two distinct dose-related patterns of adverse events were observed. A "linear" rising with increasing dose was found for cushingoid phenotype, ecchymosis, leg oedema, mycosis, parchment-like skin, shortness of breath and sleep disturbance. A "threshold pattern" describing an elevated frequency of events beyond a certain threshold value was observed at dosages of over 7.5 mg/day for glaucoma, depression/listlessness and increase in blood pressure. Dosages of 5 mg/day or more were associated with epistaxis and weight gain. A very low threshold was seen for eye cataract (<5 mg/day). Conclusion The associations found are in agreement with biological mechanisms and clinical observations. As there is a paucity of real-life data on adverse effects of glucocorticoids prescribed to unselected groups of patients, these data may help the clinician to adapt therapy with glucocorticoids accordingly and improve the benefit-risk ratio.
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“A dose-related pattern was found for clinical features such as cushingoid phenotype, skin thinning, ecchymosis, and sleep disturbances.”
From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [35]
In the citing paper
“Although other adverse effects manifested above a certain threshold of daily glucocorticoid dosage (eg, epistaxis and weight gain with daily prednisone equivalent dose of > 5.0-7.5 mg), whereas depression and high blood pressure were especially prevalent with > 7.5 mg/d (35).”
From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [35]
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“5 mg/day of GC [54] in non-diabetic SLE patients is greater the more chronic the treatment with steroids and the risk of diabetes is [51,55,56].”
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“UC patients using steroids, and particularly those using high-dose steroids for a long period, are also at risk for adverse drug reactions and complications [9–11], including increased body weight and acne as less serious effects, and more serious complications such as reduced glucose tolerance, reduced bone density,…”
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Background
Metadata
- Authors
- Huscher, D., Thiele, K., Gromnica-Ihle, E., Hein, G., Demary, W., Dreher, R., Zink, A., & Buttgereit, F.
- Affiliations
- German Rheumatism Research Centre (DE)
- Jena University Hospital (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Huscher, D
- Venue
- Annals of the Rheumatic Diseases
- Publisher
- Elsevier BV
- Published
- 2009-07
- Volume
- 68
- Issue
- 7
- Pages
- 1119-1124
- ISSN
- 0003-4967 (ISSN-L)
- OpenAlex
- W2167459187
- Cited by
- 604
- References
- 35
- Citations by year
- 2026: 43 · 2025: 55 · 2024: 67 · 2023: 55 · 2022: 47 · 2021: 41 · 2020: 49 · 2019: 38 · 2018: 27 · 2017: 28 · 2016: 32 · 2015: 21 · 2014: 26 · 2013: 28 · 2012: 19
- FWCI
- 6.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of the Rheumatic Diseases (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- glucocorticoid adverse effects, dose-response relationship, rheumatoid arthritis, prednisone-equivalent dose, glaucoma, cataract, depression, hypertension, weight gain, bruising, lower limb edema, fungal infection, sleep disorders, risk-benefit ratio, threshold dose
- MeSH terms
- Arthritis, Rheumatoid, Data Collection, Dose-Response Relationship, Drug, Female, Glucocorticoids, Humans, Male, Middle Aged, Risk Factors, Time Factors
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