THE ANALYSIS STUDY OF SAFETY AND LONG-TERM EFFECTS OF GLUCOCORTICOIDS IN TREATMENT OF INFLAMMATORY RHEUMATIC DISEASE: A COMPREHENSIVE SYSTEMATIC REVIEW

Authors

  • Fahmi Fathul Rahman Faculty of Medicine, Malahayati University, Bandar Lampung City, Lampung, Indonesia Author
  • Septa Istiana Faculty of Medicine, Malahayati University, Bandar Lampung City, Lampung, Indonesia Author

DOI:

https://doi.org/10.61841/jhkrgs83

Keywords:

Glucocorticoids, rheumatic, inflammation, effects.

Abstract

Background: Glucocorticoids (GCs) are often the first-line therapy for autoimmune diseases including many neurological conditions. Their use is commonly associated with complications and comorbidities. These include both immediate and long-term complications that are often related to the dose and cumulative dose of GCs. 

The aim: The aim of this study to show about safety and long term effects of glucocorticoids in treatment of inflammatory rheumatic disease.

Methods: By the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. This search approach, publications that came out between 2014 and 2024 were taken into account. Several different online reference sources, like Pubmed, SagePub, and Sciencedirect were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done.

Result: Eight publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles.

Conclusion: Glucocorticoids are effective drugs for many rheumatic diseases. However, there are serious adverse effects that can ensue. These are often dose related and related to the duration of therapy. Several of the complications occur in patients already at risk for these adverse events. The adverse effects, such as weight gain, osteoporosis, fracture, osteonecrosis, infections, ocular complications, cardiovascular effects, hyperglycemia, etc.

References

Kavanaugh A, Wells AF. Benefits and risks of low-dose glucocorticoid treatment in the patient with rheumatoid arthritis. Rheumatology (Oxford). 2014;53(10):1742–51.

Hwang YG, Saag K. The safety of low-dose glucocorticoids in rheumatic diseases: Results from observational studies. Neuroimmunomodulation. 2014;22:72–82.

Gensler LS. Glucocorticoids: Complications to Anticipate and Prevent. The Neurohospitalist. 2013;3(2):92–7.

Guski LS, Jürgens G, Pedder H, Levinsen NKG, Andersen SE, Welton NJ, et al. Monotreatment with Conventional Antirheumatic Drugs or Glucocorticoids in Rheumatoid Arthritis: A Network Meta-Analysis. JAMA Netw Open. 2023;6(10):E2335950.

Riley TR, George MD. Risk for infections with glucocorticoids and DMARDs in patients with rheumatoid arthritis. RMD Open. 2021;7(1):1–7.

Cooper C, Bardin T, Brandi ML, Cacoub P, Caminis J, Civitelli R, et al. Balancing benefits and risks of glucocorticoids in rheumatic diseases and other inflammatory joint disorders: new insights from emerging data. An expert consensus paper from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Aging Clin Exp Res. 2016;28(1):1–16.

Morgan C, Costello RE, Ray DW, Dixon WG. How Do Glucocorticoids Used in Rheumatic Disease Affect Body Weight? A Narrative Review of the Evidence. Arthritis Care Res. 2020;72(4):489–97.

Hua C, Buttgereit F, Combe B. Glucocorticoids in rheumatoid arthritis: Current status and future studies. RMD Open. 2020;6(1):1–9.

Muller S, Hider SL, Singh Sokhal B, Lawton SA, Helliwell T, Mallen CD. Long-term use of glucocorticoids for polymyalgia rheumatica: follow-up of the PMR Cohort Study. Rheumatol Adv Pract. 2022;6(2):1–10.

Hua L, Du H, Ying M, Wu H, Fan J, Shi X, et al. Efficacy and safety of low-dose glucocorticoids combined with methotrexate and hydroxychloroquine in the treatment of early rheumatoid arthritis: A single-center, randomized, double-blind clinical trial. Med (United States). 2020;99(27):E20824.

So H, Lam TO, Meng H, Lam SHM, Tam LS. Time and dose-dependent effect of systemic glucocorticoids on major adverse cardiovascular event in patients with rheumatoid arthritis: A population-based study. Ann Rheum Dis. 2023;82(11):1387–93.

Waljee AK, Rogers MAM, Lin P, Singal AG, Stein JD, Marks RM, 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.

Shbeeb I, Challah D, Raheel S, Crowson CS, Matteson EL. Comparable Rates of Glucocorticoid‐Associated Adverse Events in Patients With Polymyalgia Rheumatica and Comorbidities in the General Population. Arthritis Care Res (Hoboken) [Internet]. 2018 Apr 22;70(4):643–7. Available from: https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/acr.23320

Barbulescu A, Sjölander A, Delcoigne BDSDS, Askling J, Frisell T. Glucocorticoid exposure and the risk of serious infections in rheumatoid arthritis: A marginal structural model application. Rheumatol (United Kingdom). 2023;62(10):3391–9.

Spinelli FR, Garufi C, Mancuso S, Ceccarelli F, Truglia S, Conti F. Tapering and discontinuation of glucocorticoids in patients with rheumatoid arthritis treated with tofacitinib. Sci Rep [Internet]. 2023;13(1):1–7. Available from: https://doi.org/10.1038/s41598-023-42371-z

Boers M, Hartman L, Opris-Belinski D, Bos R, Kok MR, Da Silva JAP, et al. Low dose, add-on prednisolone in patients with rheumatoid arthritis aged 65+: The pragmatic randomised, double-blind placebo-controlled GLORIA trial. Ann Rheum Dis. 2022;81(7):925–36.

Baker E. Is there a safe and effective way to wean patients off long-term glucocorticoids? Br J Clin Pharmacol. 2021;87(1):12–22.

Floris A, Piga M, Chessa E, Congia M, Erre GL, Angioni MM, et al. Long-term glucocorticoid treatment and high relapse rate remain unresolved issues in the real-life management of polymyalgia rheumatica: a systematic literature review and meta-analysis. Clin Rheumatol [Internet]. 2022;41(1):19–31. Available from: https://doi.org/10.1007/s10067-021-05819-z

Cutolo M, Paolino S, Gotelli E. Glucocorticoids in rheumatoid arthritis still on first line: the reasons. Expert Rev Clin Immunol [Internet]. 2021;17(5):417–20. Available from: https://doi.org/10.1080/1744666X.2021.1903319

Pofi R, Caratti G, Ray DW, Tomlinson JW. Treating the Side Effects of Exogenous Glucocorticoids; Can We Separate the Good From the Bad? Endocr Rev [Internet]. 2023;44(6):975–1011. Available from: https://doi.org/10.1210/endrev/bnad016

Laugesen K, Jørgensen JOL, Sørensen HT, Petersen I. Systemic glucocorticoid use in Denmark: A population-based prevalence study. BMJ Open. 2017;7(5):1–5.

Karas PL, Goh SL, Dhital K. Is low serum albumin associated with postoperative complications in patients undergoing cardiac surgery?: Table 1: Interact Cardiovasc Thorac Surg [Internet]. 2015 Sep 10;ivv247. Available from: https://academic.oup.com/icvts/article-lookup/doi/10.1093/icvts/ivv247

Santiago T, Da Silva JAP. Safety of glucocorticoids in rheumatoid arthritis: Evidence from recent clinical trials. Neuroimmunomodulation. 2014;22:57–65.

Nikas SN. Long-term treatment with low dose glucocorticoids in Rheumatoid Arthritis: New tricks of an old drug. Mediterr J Rheumatol. 2018;29(1):13–6.

Boers M. Viewpoint: Glucocorticoids in the treatment of rheumatoid arthritis: Points to (re)consider. Rheumatol (United Kingdom). 2023;62(11):3534–7.

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Published

2024-09-18

How to Cite

Rahman, F. F., & Istiana, S. (2024). THE ANALYSIS STUDY OF SAFETY AND LONG-TERM EFFECTS OF GLUCOCORTICOIDS IN TREATMENT OF INFLAMMATORY RHEUMATIC DISEASE: A COMPREHENSIVE SYSTEMATIC REVIEW. Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425), 10(9), 6-15. https://doi.org/10.61841/jhkrgs83

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