Dose-related patterns of glucocorticoid-induced side effects

Huscher, Dörte; Thiele, Kathi; Gromnica‐Ihle, Erika; Hein, Gert; Demary, W.; Dreher, R.; Zink, Angela; Buttgereit, Frank

doi:10.1136/ard.2008.092163

Cited by 431 publications

(287 citation statements)

References 30 publications

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“…In a study using the national database of the German Collaborative Arthritis Centre, the prevalence of self-reported cataract was higher for any GC users (including those taking <5 mg prednisone daily) whereas the prevalence of self-reported glaucoma was only increased in those taking >7.5 mg daily [ 38 ]. In a nested case-control analysis within a historic RA cohort, long-term, low-dose prednisone treatment was significantly associated with development of cataract [ 31 ].…”

Section: Eyementioning

confidence: 97%

The Prediction and Monitoring of Toxicity Associated with Long-Term Systemic Glucocorticoid Therapy

et al. 2015

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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, gastrointestinal, 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.

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Section: Eyementioning

confidence: 97%

The Prediction and Monitoring of Toxicity Associated with Long-Term Systemic Glucocorticoid Therapy

et al. 2015

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“…Unfortunately, chronic systemic glucocorticoid use is also associated with a potentially severe adverse effect profile that is a significant source of iatrogenic illness among patients with chronic disease (12,13). Glucocorticoids initiate their effects via a range of genomic and nongenomic mechanisms, many of which rely on interactions with membrane-bound or cytosolic glucocorticoid receptors (14).…”

Section: Macrophage Migration Inhibitory Factor (Mif)mentioning

confidence: 99%

Identification of Iguratimod as an Inhibitor of Macrophage Migration Inhibitory Factor (MIF) with Steroid-sparing Potential

Bloom

Metz

Nalawade

et al. 2016

Journal of Biological Chemistry

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Edited by Dennis VoelkerMacrophage migration inhibitory factor (MIF) is a pleiotropic cytokine that has been implicated in a broad range of inflammatory and oncologic diseases. MIF is unique among cytokines in terms of its release profile and inflammatory role, notably as an endogenous counter-regulator of the anti-inflammatory effects of glucocorticoids. In addition, it exhibits a catalytic tautomerase activity amenable to the design of high affinity small molecule inhibitors. Although several classes of these compounds have been identified, biologic characterization of these molecules remains a topic of active investigation. In this study, we used in vitro LPS-driven assays to characterize representative molecules from several classes of MIF inhibitors. We determined that MIF inhibitors exhibit distinct profiles of anti-inflammatory activity, especially with regard to TNF␣. We further investigated a molecule with relatively low anti-inflammatory activity, compound T-614 (also known as the anti-rheumatic drug iguratimod), and found that, in addition to exhibiting selective MIF inhibition in vitro and in vivo, iguratimod also has additive effects with glucocorticoids. Furthermore, we found that iguratimod synergizes with glucocorticoids in attenuating experimental autoimmune encephalitis, a model of multiple sclerosis. Our work identifies iguratimod as a valuable new candidate for drug repurposing to MIF-relevant diseases, including multiple sclerosis.

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“…Adverse events due to corticosteroids are of concern because steroid-derived side effects can be obstacles in clinical courses of ITP therapy, especially in elderly people; 10 the peaks of etiology in ITP exist in elderly people as well as in children. 19 The incidence of steroid-derived adverse events, in general, depends greatly on both the average dose and cumulative duration of use, 20 indicating that it is essential to both complete whole courses of therapy in as a short period as possible and reduce the total amount of administered corticosteroids. In this respect, although the Dex arm required higher amounts of corticosteroids especially in the Dex with posttherapy subgroup, the lower frequency of adverse events was likely due to the shorter therapeutic periods.…”

Section: Discussionmentioning

confidence: 99%

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Dose-related patterns of glucocorticoid-induced side effects

Cited by 431 publications

References 30 publications

The Prediction and Monitoring of Toxicity Associated with Long-Term Systemic Glucocorticoid Therapy

The Prediction and Monitoring of Toxicity Associated with Long-Term Systemic Glucocorticoid Therapy

Identification of Iguratimod as an Inhibitor of Macrophage Migration Inhibitory Factor (MIF) with Steroid-sparing Potential

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