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.2016.02.1239

Cited by 78 publications

(49 citation statements)

References 35 publications

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“…Glucocorticoids at physiological concentrations have a potentially essential role in the process of bone development and homeostasis. [ 1 ] However, administration of glucocorticoids for a long duration results in Cushing disease which has a negative effect on bone health and may be associated with an increased risk of bone fracture. [ 2 ] The long-term use of exogenous glucocorticoids as anti-inflammatory or immunosuppressive agents for the management of acute and chronic inflammatory disorders e.g.…”

Section: Introductionmentioning

confidence: 99%

Effect of Intermittent Fasting on Glucose Homeostasis and Bone Remodeling in Glucocorticoid-Induced Osteoporosis Rat Model

et al. 2021

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Background: The present study examined the effect of intermittent fasting (IF) on bone mineral content (BMC) and bone mineral density (BMD) and the markers of bone remodeling in a glucocorticoid-induced osteoporosis (GIO) rat model.Methods: Forty male rats were allocated to 4 groups (N=10 per group): control group of normal rats; control+IF group (normal rats subjected to IF for 16-18 hr daily for 90 days); dexamethasone (DEX) group: (DEX [0.5 mg i.p.] for 90 days); and DEX+IF group (DEX and IF for 90 days). By the end of the experiment, BMD and BMC in the right tibia were measured. Serum levels of the following were measured: glucose; insulin; triglycerides (TGs); total cholesterol; parathyroid hormone (PTH); osteoprotegerin (OPG); receptor activator of nuclear factor-κB (RANK); bone-resorbing cytokines, including bone deoxypyridinoline (DPD), N-terminal telopeptide of collagen type I (NTX-1), and tartrate-resistant acid phosphatase 5b (TRAP-5b); and bone-forming cytokines, including alkaline phosphatase (ALP) and osteocalcin (OC).Results: DEX administration for 90 days resulted in significantly increased serum levels of glucose, insulin, TGs, cholesterol, PTH, OPG, DPD, NTX-1, and TRAP-5b and significantly decreased BMD, BMC, and serum levels of RANK, OC, and ALP (all P<0.05). IF for 90 days significantly improved all these parameters (all P<0.05).Conclusions: IF corrected GIO in rats by inhibiting osteoclastogenesis and PTH secretion and stimulating osteoblast activity.

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Section: Introductionmentioning

confidence: 99%

Effect of Intermittent Fasting on Glucose Homeostasis and Bone Remodeling in Glucocorticoid-Induced Osteoporosis Rat Model

et al. 2021

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“…At present, two main kinds of anti-inflammatory drugs are widely used clinically, steroidal anti-inflammatory drugs and nonsteroidal anti-inflammatory drugs (NSAIDs). Long-term use of steroidal anti-inflammatory drugs, such as dexamethasone and prednisone, may induce immune dysfunction, infection, and lipid metabolism disorders [6, 7]. In contrast, administration of NSAIDs, such as aspirin, ibuprofen, and indometacin, may cause gastric ulcer, coagulation disorders, and renal dysfunction [8–10].…”

Section: Introductionmentioning

confidence: 99%

Resveratrol Attenuates Microglial Activation via SIRT1‐SOCS1 Pathway

Zhang

Liu

et al. 2017

Evidence-Based Complementary and Alternative Medicine

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Microglial activation is involved in a variety of neurological disorders, and overactivated microglial cells can secrete large amount of proinflammatory factors and induce neuron death. Therefore, reducing microglial activation is believed to be useful in treating the disorders. In this study, we used 10 ng/ml lipopolysaccharide plus 10 U/ml interferon γ (LPS/IFNγ) to induce N9 microglial activation and explored resveratrol- (RSV-) induced effects on microglial activation and the underlying mechanism. We found that LPS/IFNγ exposure for 24 h increased inducible nitric oxide synthase (iNOS) and nuclear factor κB (NF-κB) p65 subunit expressions in the cells and enhanced tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) releases from the cells. RSV of 25 μM reduced the iNOS and NF-κB p65 subunit expressions and the proinflammatory factors' releases; the knockdown of silent information regulator factor 2-related enzyme 1 (SIRT1) or suppressor of cytokine signaling 1 (SOCS1) by using the small interfering RNA, however, significantly abolished the RSV-induced effects on iNOS and NF-κB p65 subunit expressions and the proinflammatory factors' releases. These findings showed that microglial SIRT1-SOCS1 pathway may mediate the RSV-induced inhibition of microglial activation in the LPS/IFNγ-treated N9 microglia.

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“…Glucocorticoid treatment complications, such as peptic ulcer, increased wound infection, and impaired wound healing, are often associated with long-term systemic use. [35][36][37] More patients in the dexamethasone group (70%) achieved excellent wound healing than those in the control group (61%). Moreover, there was a lower wound infection rate in the dexamethasone group (0%), compared to the control group (0.7%, 1 patient).…”

Section: Discussionmentioning

confidence: 97%

Pre-Emptive Incision-Site Infiltration with Ropivacaine Plus Dexamethasone for Postoperative Pain After Supratentorial Craniotomy: A Prospective Randomized Controlled Trial

Zhao¹,

Wang²,

Pan³

et al. 2021

JPR

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Background: Incision-site infiltration with local anesthetics prevents pain on incision site, but pain relief is limited to the first few postoperative hours. Dexamethasone as an adjuvant to local infiltration successfully achieves better postoperative pain relief; however, this has not been studied in craniotomy patients yet. Study Design and Methods: This is a prospective, single-center, blinded, randomized, controlled trial included patients aged between 18 and 64 years, ASA physical status of I-II, scheduled for elective supratentorial tumor craniotomy under general anesthesia. We screened patients for enrollment from April 4, 2019 through August 15, 2019. The final study visit of the last patient was conducted on February 13, 2020. We randomly assigned eligible participants (1:1) to either the dexamethasone group who received incision-site infiltration of 0.5% ropivacaine plus 0.033% dexamethasone (N=70) or the control group who received 0.5% ropivacaine alone (N=70). Primary outcome was the cumulative sufentanil consumption (μg) within 48 hours postoperatively. Primary analysis was performed based on the modified intention-to-treat (MITT) principle. Results: Baseline characteristics were similar between the groups (p>0.05). Sufentanil consumption during the first 48 hours postoperatively was 29.0 (10.7) μg in the dexamethasone group and 38.3 (13.7) μg in the control group (mean difference −9.3, 95% CI −13.4 to −5.1; p<0.001). There was no serious adverse effect directly associated with incision-site infiltration or local dexamethasone use. Conclusion:The addition of dexamethasone to pre-emptive incision-site infiltration with the local anesthetic can reduce about 27% of opioids consumption and the postoperative pain scores within 72 hours after craniotomy. Trial Registration: ClinicalTrials.Gov (NCT03618264).

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

Cited by 78 publications

References 35 publications

Effect of Intermittent Fasting on Glucose Homeostasis and Bone Remodeling in Glucocorticoid-Induced Osteoporosis Rat Model

Effect of Intermittent Fasting on Glucose Homeostasis and Bone Remodeling in Glucocorticoid-Induced Osteoporosis Rat Model

Resveratrol Attenuates Microglial Activation via SIRT1‐SOCS1 Pathway

Pre-Emptive Incision-Site Infiltration with Ropivacaine Plus Dexamethasone for Postoperative Pain After Supratentorial Craniotomy: A Prospective Randomized Controlled Trial

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