“Millions of times a year, Americans get prescriptions for a week’s worth of steroid pills, hoping to ease a backache or quell a nagging cough or allergy symptoms. But a new study suggests that they and their doctors might want to pay a bit more attention to the potential side effects of this medication.”
The research from the highly respected University of Michigan was published in the British Medical Journal (BMJ). The study involved examining data from 1.5 million adults with private insurance. None of the adults included in the study were elderly adults. During the three-year period that was examined in the study, one-fifth of the adults filled a prescription for oral corticosteroids such as prednisone. The rates of adverse events were highest within the 30-day window following the prescription, but the risks remained elevated for three months.
“Although physicians focus on the long-term consequences of steroids, they don’t tend to think about potential risks from short-term use,” Dr. Akbar Waljee, the study’s lead author, said. “We see a clear signal of higher rates of these three serious events within 30 days of filling a prescription. We need to understand that steroids do have a real risk and that we may use them more than we really need to. This is so important because of how often these drugs are used.”
According to the University of Michigan researchers, half of the prescriptions for short-term steroid pills are written for people with back pain, allergies and respiratory tract infections including bronchitis.
“For that comparison, they then looked at rates of the three complications among short-term steroid users before and after they received steroids. Sepsis rates were five times higher in the 30 days after a steroid prescription, VTE clot rates were more than three times as high, and fracture rates were nearly twice as high as those that did not take steroids.”
Science Daily then explained the risks of adverse events when comparing steroid users with non-steroid users.
“Finally, the researchers compared the steroid users with a sample of non-steroid users who had the same respiratory conditions. The difference in rates of all three health problems were still higher, as expressed by a quantity called the incidence rate ratio. Steroid users had more than five times the rate of sepsis, nearly three times the rate of VTE clots and two times the rate of fracture.”
Five times the sepsis and three times the blood clots is nothing to sneeze about!
“When we have a medication that’s being given to a large population, we can pick up signals that might inform us of some potentially harmful side effects that we might otherwise miss in smaller studies,” Waljee says. “Analyzing large data sets like this is a goal of groups like MiCHAMP and can help us see these trends sooner, highlighting the importance of this type of research on Big Data.”
Dr. Waljee of the University of Michigan says that with this information, he now advises patients and prescribes the smallest amounts of corticosteroids possible and only when needed to better avoid adverse events.
