Prevention and management of glucocorticoid-induced side effects: A comprehensive review

Caplan, Arthur; Fett, Nicole; Rosenbach, Misha; Werth, Victoria P.; Micheletti, Robert G.

doi:10.1016/j.jaad.2016.02.1241

Cited by 147 publications

(90 citation statements)

References 43 publications

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“…Systemic CS use in children with AD has been studied in two RCTs, but with very small sample sizes . Based on their use in other conditions, the long‐term intermittent use of systemic CS is well known to cause a multitude of side‐effects, and even use for 30 days or less has been associated with increased rates of sepsis, venous thromboembolism and fracture . A recent systematic review of studies in children taking systemic CS for > 2 weeks found significant increases in infections, growth delay and obesity …”

Section: Approach To Systemic Corticosteroid (Cs) Use In Atopic Dermamentioning

confidence: 99%

Use of systemic corticosteroids for atopic dermatitis: International Eczema Council consensus statement

et al. 2018

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SummaryBackgroundGuidelines discourage the use of systemic corticosteroids for atopic dermatitis (AD), but their use remains widespread.ObjectivesTo reach consensus among an international group of AD experts on the use of systemic corticosteroids for AD.MethodsA survey consisting of statements accompanied by visual analogue scales ranging from ‘strongly disagree’ to ‘neutral’ to ‘strongly agree’ was distributed to the International Eczema Council (IEC). Consensus was reached in agreement on a statement if < 30% of respondents marked to the left of ‘neutral’ towards ‘strongly disagree’.ResultsSixty of 77 (78%) IEC members participated. Consensus was reached on 12 statements, including that systemic corticosteroids should generally be avoided but can be used rarely for severe AD under certain circumstances, including a lack of other treatment options, as a bridge to other systemic therapies or phototherapy, during acute flares in need of immediate relief, in anticipation of a major life event or in the most severe cases. If used, treatment should be limited to the short term. Most respondents agreed that systemic corticosteroids should never be used in children, but consensus was not reached on that statement. The conclusions of our expert group are limited by a dearth of high‐quality published evidence. If more stringent consensus criteria were applied (e.g. requiring < 20% of respondents marking towards ‘strongly disagree’), consensus would have been reached on fewer statements.ConclusionsBased on expert opinion from the IEC, routine use of systemic corticosteroids for AD is generally discouraged and should be reserved for special circumstances.

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Section: Approach To Systemic Corticosteroid (Cs) Use In Atopic Dermamentioning

confidence: 99%

Use of systemic corticosteroids for atopic dermatitis: International Eczema Council consensus statement

et al. 2018

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“…The median number of times that transitional treatments were received per patient was 3 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. The median number of times that transitional treatments were received per patient was 3 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

Section: Resultsmentioning

confidence: 99%

“…13 Given the adverse event profiles of the 2 transitional therapies, GON injections may be more favorable to oral steroids as it limits systemic exposure to steroids with a targeted local treatment, though this should be verified in a prospective study. If given long term, there is also increased risk of glucose intolerance, increased weight gain, hypertension, immunosuppression, and bone density loss.…”

Section: Discussionmentioning

confidence: 99%

Greater Occipital Nerve Injection versus Oral Steroids for Short Term Prophylaxis of Cluster Headache: A Retrospective Comparative Study

Wei

Robbins

2018

Headache

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“…However, chronic corticosteroid use is associated with significant morbidity, and the lowest effective dose is recommended if chronic use is needed to maintain disease control. 80 Disfiguring or destructive lesions, widespread involvement, or refractory lesions may respond to corticosteroids at doses ranging from 40 to 80 mg/day then tapered over the course of months. 77 Alternate steroid-based treatments, such as repository corticotropin injection, have been used for some patients with recalcitrant disease.…”

Section: Systemic Immunosuppressive Therapiesmentioning

confidence: 99%

Cutaneous Sarcoidosis

Caplan

Rosenbach

Imadojemu

2020

Semin Respir Crit Care Med

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Sarcoidosis is a chronic, multisystem, inflammatory disorder of unknown etiology that is characterized by noncaseating granulomas that impair normal organ functioning. Sarcoidosis predominantly affects the lungs, but the skin is often cited as the second most frequently involved organ. Cutaneous manifestations of sarcoidosis are highly variable and ongoing research seeks to better understand the relationship between clinical morphology and disease prognosis. Skin findings in patients with sarcoidosis can be “specific,” in which sarcoidal granulomas infiltrate the skin, or they can represent a “nonspecific” reactive inflammatory process, as is seen in calcinosis cutis and erythema nodosum. Cutaneous sarcoidosis can be the initial presenting sign or develop later in the course of the disease. In some patients, the skin will be the most involved and impactful organ system and will drive therapy. In other cases, the skin will be an incidental or minor finding, but may be easily accessible for biopsy to confirm the diagnosis. There are many potential therapies for sarcoidosis, though no one therapy is universally effective.

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Prevention and management of glucocorticoid-induced side effects: A comprehensive review

Cited by 147 publications

References 43 publications

Use of systemic corticosteroids for atopic dermatitis: International Eczema Council consensus statement

Use of systemic corticosteroids for atopic dermatitis: International Eczema Council consensus statement

Greater Occipital Nerve Injection versus Oral Steroids for Short Term Prophylaxis of Cluster Headache: A Retrospective Comparative Study

Cutaneous Sarcoidosis

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