Short-Term Use of Oral Corticosteroids Linked to Adverse Events

Short-term use of oral corticosteroids is linked with greater risk of adverse events such as sepsis, venous thromboembolism, and fracture, researchers reported.

Using a nationwide dataset of private insurance claims from 2012 to 2014, researchers examined data from approximately 1.5 million adults aged 18 to 64 years.

During the 3-year period analyzed in this observational study, approximately 20% of adults received prescriptions for short-term (less than 30 days duration) use of oral corticosteroids. Most often, oral corticosteroids were prescribed for treating upper respiratory tract infections, spinal conditions, and allergies. Women, older patients, and white adults had the most frequent use of the medication.

Analysis indicated that use of oral corticosteroids was associated with an increase in adverse events within 30 days of when patients started taking the drug, compared with patients who did not receive oral corticosteroids. Rates of sepsis (incident rate ratio, 5.30; 95% confidence interval, 3.80 to 7.41), venous thromboembolism (3.33; 2.78 to 3.99), and fracture (1.87; 1.69 to 2.07) were all increased, though the risks decreased during the next 31 to 90 days. Even doses of prednisone that were less than 20 mg/day were tied to an increased risk of sepsis, venous thromboembolism, and fracture.
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The researchers noted that both generalists and specialists prescribed oral corticosteroids. “Importantly, these prescriptions were associated with statistically significantly higher rates of sepsis, venous thromboembolism, and fracture despite being used for a relatively brief duration,” the study’s authors wrote.

They added, “Additional studies are needed to identify optimal use of corticosteroids and to explore whether treatment alternatives may improve patient safety.”

—Lauren LeBano

Reference

Waljee AK, Rogers MAM, Lin P, et al. Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. BMJ. 2017;357:j1415.