Systemic corticosteroid therapy---side effects and their management

Stanbury, Rosalyn M; Graham, Elizabeth

doi:10.1136/bjo.82.6.704

Cited by 306 publications

(227 citation statements)

References 25 publications

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“…10,11 Corticosteroids have traditionally been used with a degree of caution owing to the well-known side effects. 12 Intravitreal triamcinolone has also been associated with side effects such as raised IOP, cataract formation, and endophthalmitis. [13][14][15][16] The most commonly reported complication associated with IVTA injection is elevation of IOP.…”

Section: Discussionmentioning

confidence: 99%

Ocular morbidity associated with intravitreal triamcinolone acetonide

Konstantopoulos¹,

Williams²,

Newsom³

et al. 2006

Eye

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Aim To report on the complications associated with the use of intravitreal triamcinolone acetonide (IVTA) in a tertiary referral hospital setting. Materials and methods A retrospective case series review of all IVTA injections carried out over a period of 30 months. Results One hundred and thirty IVTA injections were performed; nine with limited local follow-up were excluded. Thus, 121 injections (108 patients, 114 eyes) were included in the study. Triamcinolone (4 mg) was used in all cases. Indications were diabetic macular oedema (n ¼ 41 eyes), retinal vein occlusions (n ¼ 27), postoperative cystoid macular oedema (n ¼ 24), exudative age-related macular degeneration (n ¼ 16), and others (n ¼ 6). No intraoperative complications were recorded. Postoperative intraocular pressure (IOP) readings of 22, 28, 35, and 40 mmHg or higher were recorded in 46.5, 29.8, 12.3, and 7.9% of eyes, respectively. IOP elevation was treated with antiglaucoma medication in all but one eye (0.9%) that required trabeculectomy and one (0.9%) that required vitrectomy with cataract extraction for suspected phacoanaphylactic glaucoma. Two eyes (1.8%) developed retinal detachment; both had previously been treated for retinal breaks. One eye (0.9%) developed culture-positive endophthalmitis. Conclusions Significant morbidity is associated with IVTA injection; clinicians should be aware when considering treatment options.

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Section: Discussionmentioning

confidence: 99%

Ocular morbidity associated with intravitreal triamcinolone acetonide

Konstantopoulos¹,

Williams²,

Newsom³

et al. 2006

Eye

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“…An estimated 0.5% to 1% of patients in the general population and as many as 2.5% of older adults are characterized as chronic corticosteroid users [6]. Although systemic corticosteroids have proven short-term immunosuppressant and antiinflammatory effects, the long-term use of these agents is associated with a myriad of complications including central obesity, skin thinning, fluid and electrolyte imbalance, adrenal insufficiency, and psychological disturbance [23].…”

Section: Introductionmentioning

confidence: 99%

Does Chronic Corticosteroid Use Increase Risks of Readmission, Thromboembolism, and Revision After THA?

Boylan

Perfetti

Elmallah

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Systemic corticosteroids are commonly used to treat autoimmune and inflammatory diseases, but they can be associated with various musculoskeletal problems and disorders. There currently is a limited amount of data describing the postoperative complications of THA associated specifically with chronic corticosteroid use. Questions/purposes For chronic corticosteroid users undergoing THA, we asked: (1) What is the risk of hospital readmission at 30 and 90 days after surgery? (2) What is the risk of venous thromboembolism at 30 and 90 days after surgery? (3) What is the risk of revision hip arthroplasty at 12 and 24 months after surgery? Methods We identified patients in the Statewide Planning and Research Cooperative System who underwent primary THA between January 2003 and December 2010. This database provides hospital discharge abstracts for all admissions in the state of New York each year. We used propensity scores to three-to-one match the 402 chronic corticosteroid users with a comparison cohort of 1206 patients according to age, sex, race, comorbidity score, year of surgery, and hip osteonecrosis. The risk of each outcome was compared between chronic corticosteroid users and the matched cohort. Because multiple comparisons were made, we considered p less than 0.008 as statistically significant. Results Readmission was more common for corticosteroid users at 30 days (odds ratio [OR], 1.45; 95% CI, 1.14-1.85; p = 0.003) and 90 days (OR, 1.37; 95% CI, 1.09-1.73; p = 0.007). Venous thromboembolism was not more frequent in corticosteroid users at 30 days (OR, 2.39; 95% CI, 1.08-5.26; p = 0.031) or 90 days (OR, 1.91; 95%

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“…Clearly, the chance of significant side effects increases with the dose and the duration of corticosteroid treatment. Therefore, they have to be administered at the lowest possible dose required to control the disease [7].…”

Section: Discussionmentioning

confidence: 99%

Roflumilast is effective in reducing COPD related exacerbations and improving CAT score

Polla

2015

Monaldi Arch Chest Dis

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An 85-year-old male patient, former smoker (60 pack-years) and railway man, came to our clinic for the first time in 2005. Post bronchodilator (BD) forced expiratory volume in the first second (FEV 1 ) was 0.89 L (36% of predicted), residual volume (RV) was 172% of predicted, forced vital capacity (FVC) was 2.33 L (70% of predicted) and FEV 1 /FVC was 0.38. He was diagnosed with severe chronic obstructive pulmonary disease (COPD). At the time of the first visit, the patient was under daily treatment with tiotropium 18 μg/day, salmeterol 100 μg/day, fluticasone 1000 μg/day and theophylline Keywords: Roflumilast, COPD, Case report, Exacerbations, Steroid therapy. We present a case of a 85-year-old man who suffered from several chronic obstructive pulmonary disease (COPD) related exacerbations and hospitalizations. Traditional therapy, which also included intramuscular steroid therapy, did not help and caused several drug related adverse events. After yet another exacerbation followed by hospitalization at the intensive care unit, it was decided to start roflumilast treatment. In the year after beginning treatment, the patient did not experience any more exacerbations and his lung function also improved, as recorded by the COPD assessment test (CAT) score and improved forced expiratory volume in the first second (FEV 1 ) value. In this patient roflumilast seems to be effective in reducing exacerbations, an important goal to be achieved in COPD patients. Monaldi Arch Chest Dis 2013; 79: 3-4, Suppl., 41-44. This work originated from the Respiratory Physiopathology and Anti

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Systemic corticosteroid therapy---side effects and their management

Cited by 306 publications

References 25 publications

Ocular morbidity associated with intravitreal triamcinolone acetonide

Ocular morbidity associated with intravitreal triamcinolone acetonide

Does Chronic Corticosteroid Use Increase Risks of Readmission, Thromboembolism, and Revision After THA?

Roflumilast is effective in reducing COPD related exacerbations and improving CAT score

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