Taoyuan, Taiwan—Adverse effects from long-term use of oral corticosteroids are well documented, but a new study suggests that shorter-term oral-steroid prescriptions can also be risky.

The report in Annals of Internal Medicine looked at the association between steroid bursts, defined as a course of 14 days or less, and severe adverse events, specifically gastrointestinal (GI) bleeding, sepsis, and heart failure.

The self-controlled case series used the entire National Health Insurance Research Database of medical claims records in Taiwan. Included in the study were adults aged 20 to 64 years with continuous enrollment in the National Health Insurance program from January 1, 2013, to December 31, 2015.

Researchers calculated incidence rates of severe adverse events in steroid-burst users and nonsteroid users, as well as incidence rate ratios (IRRs) for severe adverse events within 5 to 30 and 31 to 90 days after initiation of steroid therapy.

Of 15.8 million adult participants, 2.6 million who received a single steroid burst were included. Researchers determined that the most common indications were skin disorders and respiratory tract infections.

The study determined that incidence rates per 1,000 person-years in steroid bursts were 27.1 (95% CI, 26.7-27.5) for GI bleeding, 1.5 (CI, 1.4-1.6) for sepsis, and 1.3 (CI, 1.2-1.4) for heart failure.

Furthermore, according to the report, rates of GI bleeding (IRR, 1.80; CI, 1.75-1.84), sepsis (IRR, 1.99; CI, 1.70- 2.32), and heart failure (IRR, 2.37; CI, 2.13- 2.63) significantly increased within 5 to 30 days after steroid therapy initiation and attenuated during the subsequent 31 to 90 days.

“Oral corticosteroid bursts are frequently prescribed in the general adult population in Taiwan. The highest rates of GI bleeding, sepsis, and heart failure occurred within the first month after initiation of steroid therapy,” the authors conclude.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

 « Click here to return to Weekly News Update.