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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Huscher, D. (2015) · Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver · doi:10.17169/refubium-11320
Self-citationAre patients being treated with immunosuppression for ocular inflammatory disease adequately?
Cocho, L., Swan, R. T., & Foster, S. C. (2015) · Expert Review of Ophthalmology · doi:10.1586/17469899.2015.1066248
“5 mg/day of oral prednisone for >6 months [29].”
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Han, B. K., Yachoui, R., & Yi, K. (2012) · Rheumatology International · doi:10.1007/s00296-012-2456-7
Early Weight Gain and Obesity in Childhood Acute Lymphoblastic Leukemia
Withycombe, J. S. (2012) · UA Campus Repository (The University of Arizona)
Glukokortikoidi v nefrologiji I: farmakologija in stranski učinki
Pajek, J., & Jensterle, M. (2015) · Slovenian Medical Journal · doi:10.6016/zdravvestn.1236
Посттрансплантационный сахарный диабет. Обзор литературы
Шамхалова, М. Ш., Shestakova, M. V., & Sechenov, I. M. (2015)
Sicherheit der Rheumatherapie im Alter
Gesichtspunkte, A. (2014)
Rao, K. V. P., & Kumar, K. P. (2018) · Journal of Nephrology & Therapeutics · doi:10.4172/2161-0959.1000304
Lightner, A. L. (2018) · Inflammatory Bowel Diseases · doi:10.1093/ibd/izy084
Nouveaux concepts destinés à réduire la toxicité des glucocorticoïdes
Alten, R., & Weinbrecht-Mischkewitz, M. (2019) · Revue du Rhumatisme · doi:10.1016/j.rhum.2019.08.009
Padula, W. V., Cordero‐Coma, M., Yilmaz, T., Padula, W. V., Gallagher, M. J., & Campbell, J. D. (2015) · Journal of health economics and outcomes research · doi:10.36469/9895
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Treat-to-Target bei systemischem Lupus erythematodes
Aringer, M., Leuchten, N., & Schneider, M. (2020) · Kompass Autoimmun · doi:10.1159/000507644
Initial hydroxychloroquine monotherapy in systemic lupus erythematosus: report of three cases
Ichikawa, K., Kirino, Y., Kunishita, Y., Kishimoto, D., Takase‐Minegishi, K., Yoshimi, R., & Nakajima, H. (2021) · Modern Rheumatology Case Reports · doi:10.1080/24725625.2021.1881215
Sleep Patterns and Associated Factors in Children and Adolescents with Inflammatory Bowel Disease
Szabo, M. M. (2016) · doi:10.33915/etd.6760
“However, the authors noted that they did not assess patient use of corticosteroids, which has been shown to disrupt sleep (Huscher et al., 2009), and thus they are unable to determine the mechanism underlying the sleep disturbance.”
BackgroundDrug Candidates for Covid-19 Treatment in Brazil
Silva, L. P. (2021) · Clinical Cardiology and Cardiovascular Interventions · doi:10.31579/2641-0419/200
Saadoun, D. (2020) · EMC - Tratado de Medicina · doi:10.1016/s1636-5410(20)43348-3
Is There a Safe Systemic Corticosteroid Dose?
Wakefield, D., Yates, W. B., & McCluskey, P. (2022) · Ocular Immunology and Inflammation · doi:10.1080/09273948.2022.2027467
“This important observation has been substantiated in several studies.(3,4)”
ResultImpact of Drugs on Diabetes Risk and Glycemic Control
Frontoni, S., & Picconi, F. (2018) · Endocrinology · doi:10.1007/978-3-319-27316-7_19-1
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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