Investigation of Glucocorticoid-induced Side Effects in Patients with Autoimmune Diseases

Abstract

High dose glucocorticoids (GC) are commonly used for the treatment of autoimmune diseases. The frequencies, occurrence day and dose-dependency for side eŠects may be diŠerent among the events such as diabetes mellitus, hyperlipidemia, infectious disease, osteoporosis, and peptic ulcer. We investigated GC-induced side eŠects in 68 patients treated with GC for autoimmune diseases. Initial dose of GC (prednisolone equivalent) was 0.67±0.35 mg/kg/d. Hypercholesterolemia (66％), hypertension (62％), insomnia (50％), hypertriglyceridemia (44％), excessive appetite (38％), hyperglycemia (18％), digestive symptom (16％), moon-shaped face (13％) and oral candidiasis (12％) were observed in 63 patients treated with GC. Hypercholesterolemia, excessive appetite, digestive symptom, moon-shaped face, and oral candidiasis were associated with the initial dose of prednisolone greater than 0.80 mg/kg/d. )] were developed after 33 60 days starting GC. Since the frequencies, dose-dependency and occurrence day were diŠerent among the side eŠects of GC, medical staŠs including physicians and pharmacists should pay attention such features of the events in the treatment of autoimmune diseases.

Pharmacokinetic Evaluation of Chitosan-Succinyl-Prednisolone Conjugate Microparticles as a Colonic Delivery System: Comparison with Enteric-Coated Conjugate Microparticles

“…However, as PD causes severe toxic side effect considerably in a prolonged use or high dose, its use is generally limited [10] [11]. It is important for enhancement of efficacy and reduction of toxic side effect to deliver an anti-inflammatory drug to the diseased site specifically.…”

Early diagnosis and treatment of steroid-induced diabetes mellitus in patients with rheumatoid arthritis and other connective tissue diseases

“…We have previously reported that PSL-induced hyperglycemia developed about three months after the start of PSL administration, in contrast to hypertension, hyperlipidemia, and insomnia, which appeared just after PSL administration [24]. Combination therapy comprising twice or three times daily administration of PSL, nateglinide, and acarbose seems to be effective in GC-DM patients, but its efficacy is lower in patients who have recently been started on GC or those who increased their dose of GC just before the combination therapy.…”

“…Combination therapy comprising twice or three times daily administration of PSL, nateglinide, and acarbose seems to be effective in GC-DM patients, but its efficacy is lower in patients who have recently been started on GC or those who increased their dose of GC just before the combination therapy. This is probably because their PSL-induced hyperglycemia worsened three months after the introduction of PSL [24]. This may also be why the period from the start of PSL administration to the intervention in patients who were well controlled at three months was significantly longer than that in poorly controlled patients.…”

Cardiovascular Events in Systemic Lupus Erythematosus: Mechanisms for the Accelerated Development of Atherosclerosis, Diagnosis, Correction Capabilities

“…Глюкокортикоиды, которые традиционно применя-ются для лечения СКВ, могут индуцировать: артериаль-ную гипертензию (62%), сахарный диабет (18%), дисли-пидемию (66%) и тромбоэмболические осложнения [71,72]. Считается, что ГК увеличивают суммарный риск раз-вития ССЗ, хотя ряд авторов и не подтверждают данное предположение [73].…”