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Internist (Berl). 2016 Sep;57(9):934-9. doi: 10.1007/s00108-016-0098-7.

[Long-term glucocorticoid therapy : Is there a safe dosage?].

[Article in German]

Author information

1
Medizinische Klinik mit Schwerpunkt Rheumatologie und klinische Immunologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. cindy.strehl@charite.de.
2
Deutsches Rheuma-Forschungszentrum (DRFZ), Berlin, Deutschland. cindy.strehl@charite.de.
3
Medizinische Klinik mit Schwerpunkt Rheumatologie und klinische Immunologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
4
Deutsches Rheuma-Forschungszentrum (DRFZ), Berlin, Deutschland.

Abstract

Glucocorticoids have been successfully used for a long time to treat a wide range of chronic inflammatory diseases. Despite the well-accepted efficacy, possible adverse effects still provoke discussions among patients and physicians. In particular, the long-term use of glucocorticoids at higher dosages may cause unwanted adverse effects; therefore, the question arises if conditions for a safe long-term treatment regimen with these drugs can be defined. Studies specifically and comprehensively addressing this question are missing; therefore, a multidisciplinary task force comprised of medical experts and patients was formed to analyze and discuss the existing literature in order to identify conditions where long-term glucocorticoid treatment has an acceptably low level of harm. The group agreed that the actual level of harm of long-term glucocorticoid therapy depends on both drug (dose and duration) and patient-specific characteristics. The patient-specific parameters (some of which can be modified by patients and/or physicians) should always be monitored before and during treatment with glucocorticoids and optimized if necessary. A positive benefit-risk ratio can be achieved when current knowledge and existing recommendations are kept in mind and implemented in clinical practice.

KEYWORDS:

Adverse events; Benefit-risk ratio; Patient specific factors; Rheumatoid arthritis; Risk factors

PMID:
27351788
DOI:
10.1007/s00108-016-0098-7
[Indexed for MEDLINE]

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