The Dangers of Steroids

iStock-174295373Have you ever taken corticosteroids? I have, once, following a serious bout of poison ivy, and while at the time I really needed them I might think twice today. Turns out that single, short term use of steroids may cause a host of negative side effects, a new study Rick and I discuss on PodMed this week and published in the British Medical Journal shows. And since the study also shows that over 20% of adults in the US younger than 65 years of age have been given a prescription for oral corticosteroids, that's concerning indeed.

The study took a look at private insurance claims among adults 18-64 years old between 2012-2014. This represented claims by over 1.5 million adults, of whom over 327,000 received a prescription for short term (less than 30 days) use of oral corticosteroids. Most of these folks received their prescription from a multitude of providers for upper respiratory infections, spinal conditions and allergies. More likely to take the meds were older folks, women, and white adults.

When looking at possibly associated negative side effects, the study identified a disturbing and significant increase in sepsis, venous thromboembolism, and fracture among those who took steroids, even a single, short term use. Plausibility exists for these associations since these are the self-same warnings given by the FDA with regard to prescription of these drugs.  Yikes! What can be done? Clearly, monitoring the prescription of steroids more closely and assessing these associations prospectively is needed before panic ensues. Yet for now, carefully assessing prescription of steroids is also prudent.

Other topics this week include Azithromycin and ventricular arrhythmia in CMAJ, Screening for Retinopathy in Type 1 Diabetes in NEJM, and Rapid Rule-out of Acute Myocardial Infarction With a Single High-Sensitivity Cardiac Troponin T Measurement Below the Limit of Detection: A Collaborative Meta-analysis in Annals of Internal Medicine. Until next week, y'all live well.

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