Extended corticosteroid use can significantly increase the incidence of adverse events compared with intermittent use, according to new research published in the journal Current Medical Research and Opinion

Using a privately-insured administrative database, researchers examined a total of 78,704 patients with autoimmune or inflammatory disease diagnoses between 2006 and 2015. Patients were categorized by usage: intermittent use with duration <60 days, and extended use with a duration of ≥60 days at ≤7.5 mg/day (low), >7.5-≤15 mg/day (medium), or >15 mg/day (high) prednisone-equivalent dosage.

Of the 78,704 patients, 9.5%, 11.0%, and 8.6% were classified as high-, medium, and low-dose extended corticosteroid users, respectively. Among the high-dose group, hypertension, pneumonia, and osteoporosis were the adverse events with the highest incidence rates (41.9, 27.4 and 19.8 per 1000 patient-months, respectively.)

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The authors noted that, “For most adverse events, all levels of corticosteroid use exhibited significant risks of increased incidence compared to intermittent use.” Adverse events occurred between 2.3 and 6.7 months after initiation, a relatively short period of time. Also, dose-relationships and duration-relationships were identified with some adverse events. 

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