Steroids May Be Risky Even in the Short Term

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The dangers of long-term use of corticosteroids like prednisone and cortisone are well known, but a new study suggests that even short-term use can have serious side effects.

Corticosteroids are used to treat inflammatory conditions like asthma, rheumatoid arthritis and inflammatory bowel disease as well as rashes and muscle pain. Researchers analyzed records of 1,548,945 Americans aged 18 to 64 who were enrolled in a nationwide health care insurance program from 2012 to 2014. More than a fifth of them took steroid pills for a month or less for various ailments.

The study, in BMJ, tracked the same patients during the 30 days to five months before they took oral steroids and then during the month after their prescriptions were filled. When they were on steroids, even at a relatively low dose of 20 milligrams a day or less, they had four times the risk of sepsis (blood infection), more than triple the risk of blood clots and almost twice the risk of a fractured bone. The risks increased with higher doses.

“While steroids may be appropriate in some situations, like many drugs they have side effects,” said the lead author, Dr. Akbar K. Waljee, an assistant professor of medicine at the University of Michigan. “We may use them more than we really need to. It is important to minimize their use if alternatives exist.”