signature: Valerie Goodwin
Newswise — When being treated for an upper respiratory tract infection, patients often receive a short course of oral steroids.
Oral steroids are now being prescribed at an increasing rate, and patients need to understand their effects and the alternatives available.
Research from the University of Michigan found that the number of oral steroid prescriptions has increased steadily over the past decade in the United States, Taiwan and Denmark.
The study, published in Clinical & Translational Science, found that between 2009 and 2018, overall oral steroid use increased from 6.4% to 7.7% in the United States, from 16.6% to 18.7% in Taiwan, and from 1.7% in Denmark to 2.9%.
“Oral steroids are often given to patients for a short period of time to help relieve symptoms associated with acute illnesses such as bronchitis or sinusitis, although there is little data to suggest they are beneficial in treating either condition,” says Beth Wallace, MD. Assistant Professor of Rheumatology, University of Michigan.
“We also found that steroids are often used to treat back problems and skin conditions, while other treatments may work better and have fewer side effects.”
Short-term oral steroids have long been considered a safe way to treat symptoms of these common conditions.
Recently, however, researchers have discovered that even healthy patients can develop significant side effects from repeated exposure to steroids.
Typical short-term side effects of oral steroids are insomnia, mood changes, and increases in blood pressure and blood sugar.
Patients who take oral steroids long-term may have an increased risk of heart attack, stroke, blood clots, or infection.
“The best way to reduce the risk of these negative side effects is to take the lowest dose of steroids for the shortest time and to avoid using steroids when there is no evidence that they are effective,” Wallace advises.
Wallace also encouraged health care providers to look for alternatives to short-term oral steroid prescriptions for patients when treating symptoms of self-limiting illnesses such as bronchitis or sinusitis.
“It’s becoming increasingly clear that we as physicians should be thinking about steroids from a management perspective, just like we already think about antibiotics or opioids,” Wallace said.
“By using steroids only when indicated, prescribing the lowest possible dose for the shortest time possible, and exploring other treatment avenues where feasible, we can help reduce patients’ risk for oral steroid effects.”
Additional authors include Beth I. Wallace and Akbar K. Waljee of the Center for Clinical Management Research, Lt. Col. Charles S. Kettles Veterans Affairs Medical Center, Ann Arbor, Michigan, and the Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan. use. Paul Lin, Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan, USA. Dr. Hui-Ju Tsai, Institute of Population Health Sciences, National Institutes of Health, Chunan, Taiwan, and School of Life Sciences, National Tsing Hua University, Hsinchu, Taiwan. Kristian Aasbjerg from Himmerland Eye Clinic in Aalborg, Denmark. Ann Chen Wu is from Harvard Medical School, Boston, MA, USA, and Department of Pediatrics, Children’s Hospital, Boston, MA, USA. Yifen Cai is from the Institute of Population Health Sciences, National Institutes of Health, Chunan, Taiwan. Christian Torp-Pedersen from the Department of Clinical Investigation and Cardiology, Nordsjaellands Hospital, Hillerod, Denmark, and the Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark. Yao Zhengjie, Department of Pediatric Allergy, Asthma and Rheumatology, Chang Gung Gung Memorial Hospital, Taoyuan, Taiwan, and Chang Gung Gung Memorial University School of Medicine, Taoyuan, Taiwan.
Paper citation: “Prevalence and prescription patterns of oral corticosteroids in the United States, Tivan, and Denmark, 2009-2018” American Society for Clinical Pharmacology and Therapeutics. DOI: 10.1111/cts.13649