The short-term use of oral corticosteroids has been linked to an increased risk of gastrointestinal bleeding, sepsis and heart failure, researchers at the National Health Research Institutes said yesterday.
Institute of Population Health Sciences investigator Tsai Hui-ju (蔡慧如) and Linkou Chang Gung Memorial Hospital physician Yao Tsung-chieh (姚宗杰) presented the findings of their research team at the Ministry of Health and Welfare in Taipei.
The long-term use of corticosteroids, anti-inflammatory steroids used to treat a range of conditions, have known adverse effects, such as causing fatty tissue deposits on the face and torso, resulting in “moon face” and “buffalo hump,” they said.
Photo courtesy of the Ministry of Health and Welfare
However, the risks of short-term oral use of up to 14 days had been largely unknown, they added.
The study examined more than 2 million adults in the National Health Insurance (NHI) program who from 2013 to 2015 had been prescribed the medicine, Tsai said.
The team found that within 30 days of receiving a steroid burst, patients were 1.8 times more likely to develop gastrointestinal bleeding, two times more likely to experience sepsis and 2.4 times more likely to experience heart failure, she said.
The increased risks for severe adverse effects were also observed in people who did not have a history of a chronic illness, she added.
About 25 percent of adults in the NHI system at the time of the study were prescribed a treatment of corticosteroids, the majority of whom were women (55.3 percent), and 84.5 percent of patients who received a steroid burst did not have a history of a chronic disease, Yao said.
Brief oral steroid use was most commonly prescribed in the dermatology, otolaryngology, family medicine, internal medicine and pediatrics categories, in descending order, he said, adding that dermatology and otolaryngology departments accounted for nearly 90 percent of prescriptions.
Although the study suggests that steroid use is associated with increased risks of severe adverse events, the incidence rates per 1,000 person-years in people who received the treatments were 27.1 for gastrointestinal bleeding, 1.5 for sepsis and 1.3 for heart failure, which are considered relatively low, Yao said, adding that people should not be overly concerned.
Physicians and pharmacists should reconsider whether steroid burst prescriptions are necessary if the patient’s condition could improve on its own, they said.
People who have been prescribed the medicine should continue to take them, but watch for any side effects, especially within the first month of use, and consult with their doctor if they have concerns, Yao said.
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