The safety of pulse corticosteroid therapy- Systematic review and meta-analysis

Edel, Yonatan; Avni, Tomer; Shepshelovich, Daniel; Reich, Shelley; Rozen‐Zvi, Benaya; Elbaz, Meyer; Leibovici, Leonard; Molad, Yair; Gafter‐Gvili, Anat

doi:10.1016/j.semarthrit.2019.11.006

Cited by 12 publications

(9 citation statements)

References 73 publications

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“…46 A meta-analysis revealed that the pulsed corticosteroids (>250 mg prednisone) were not associated with increased risk of side effects such as cardiac events, hyperglycemia, infections, hypertension, edema, gastrointestinal and psychiatric adverse events. 47 Due to the limited data available, the authors only managed to pool the data for the incidence of hyperglycemia and infection rate between the high-and low-dose corticosteroids groups. The meta-analysis revealed no augmented risk of hyperglycemia and infection episodes in COVID-19 patients who received high-dose corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

High-Dose versus Low-Dose Corticosteroids in COVID-19 Patients: a Systematic Review and Meta-analysis

Tan

Xin

et al. 2022

Journal of Cardiothoracic and Vascular Anesthesia

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Section: Discussionmentioning

confidence: 99%

High-Dose versus Low-Dose Corticosteroids in COVID-19 Patients: a Systematic Review and Meta-analysis

Tan

Xin

et al. 2022

Journal of Cardiothoracic and Vascular Anesthesia

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“…After 6 months, the overall response rate in both groups was higher than 60% ( 5 ). A systematic review demonstrated that in comparison to the oral steroid-treated or untreated group, intravenous pulse corticosteroid therapy did not increase the risk of adverse effects, including neuropsychiatric, metabolic effect, and infectious complications ( 12 ). Therefore, intravenous pulse corticosteroid therapy could be considered a safe option for life-threatening autoimmune diseases.…”

Section: Discussionmentioning

confidence: 99%

Pulse corticosteroid therapy in the treatment of steroid-refractory immune checkpoint inhibitor-related pneumonitis: Case report and review

2022

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Immune checkpoint inhibitors (ICIs) have demonstrated promising therapeutic outcomes in treating a variety of malignancies, but immune-related adverse events (irAE) may develop. Among all the irAE, immune-related pneumonitis was relatively common and life-threatening. High-dose corticosteroid was recommended for the initial management, but a part of patients developed steroid-refractory pneumonitis. Other immunosuppressants were recommended, but the optimal treatment is still controversial. Here, we report two cases of steroid-refractory immune-related pneumonitis who were successfully treated with pulse corticosteroid therapy. Case 1 was hepatocellular carcinoma treated with nivolumab for 5 months. She developed acute respiratory distress syndrome due to grade 4 immune-related pneumonitis that was refractory to intravenous methylprednisolone 2 mg/kg/day treatment. Methylprednisolone 500 mg for 3 days followed by 2 mg/kg/day steroid as maintenance therapy was given. Subsequently, her pneumonitis was regressed, and the endotracheal tube was successfully removed on day 9 after the start of pulse therapy. Case 2 presented with grade 4 immune-related pneumonitis in spite the use of methylprednisolone 1 mg/kg for his skin rash. Pulse corticosteroid therapy was prescribed, then his pneumonitis was completely regressed on day 12. In this report, we demonstrated the potential role of pulse corticosteroid therapy for steroid-refractory pneumonitis.

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“…Several reviews have shown that long‐term use of corticosteroid is a significant independent predictor of corticosteroid‐induced AE 11 . In contrast, one meta‐analysis showed that pulse corticosteroids are not associated with a risk of specific AE 12 . Although it should be kept in our mind that minor and serious AE such as femoral head necrosis or anaphylaxis can occur in IVMP, 13 we conclude that IVMP is one of the safe and effective treatments for progressive vitiligo vulgaris, for which effective treatments are limited.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of i.v. methylprednisolone pulse therapy for vitiligo: A retrospective study of 58 therapy experiences for 33 vitiligo patients

Wada-Irimada

Tsuchiyama

Sasaki

et al. 2021

The Journal of Dermatology

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Systemic corticosteroid is indicated for vitiligo, especially for generalized and progressive vitiligo. However, no consensus exists yet for the dosages and modalities of systemic corticosteroid treatments for vitiligo. The purpose of this study is to validate the efficacy and safety of i.v. methylprednisolone pulse therapy (IVMP) for patients with progressive generalized vitiligo. We retrospectively reviewed the medical records of vitiligo patients treated in our institute for 10 years between January 2010 and December 2019. Among 525 vitiligo patients treated in 10 years, 33 vitiligo patients (aged, 8–78 years; 18 female and 15 males) received IVMP, a single course of daily 500 mg methylprednisolone application (8 mg/kg/day for children) for 3 consecutive days. We observed that 14 of 25 (56%) achieved stable condition without lesion progression, and 12 of 19 (63%) had more than 25% repigmentation at 6 months after IVMP. A group of Vitiligo Area Scoring Index over 10 included more patients with Vitiligo Disease Activity Score of +3 and +4 disease progression at 6 months after the IVMP. We did not observe any severe adverse events relating to the IVMP procedures. In conclusion, IVMP is a safe and effective treatment for progressive generalized vitiligo.

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The safety of pulse corticosteroid therapy- Systematic review and meta-analysis

Cited by 12 publications

References 73 publications

High-Dose versus Low-Dose Corticosteroids in COVID-19 Patients: a Systematic Review and Meta-analysis

High-Dose versus Low-Dose Corticosteroids in COVID-19 Patients: a Systematic Review and Meta-analysis

Pulse corticosteroid therapy in the treatment of steroid-refractory immune checkpoint inhibitor-related pneumonitis: Case report and review

Efficacy and safety of i.v. methylprednisolone pulse therapy for vitiligo: A retrospective study of 58 therapy experiences for 33 vitiligo patients

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