Oral steroids put patients with inflammatory disease at high risk of infection

And the risk increased with higher doses.


Steroids work by decreasing inflammation and reducing the activity of the immune system. They are used to treat a variety of inflammatory diseases and conditions such as Polymyalgia rheumatica (PMR).

Polymyalgia rheumatica (PMR) is an inflammatory musculoskeletal disorder, with a lifetime risk of 2.4% for women and 1.7% for men. If undiagnosed, it can lead to devastating effects. There is little evidence to justify the use of steroid-sparing drugs in treating PMR.

A new study shedding light on the use of steroid over PMR, suggests that oral steroid use in patients significantly increased the risk of infection. This risk increase with a higher dosage.

For this study, scientists volunteered almost 40 000 adult patients with Polymyalgia rheumatica or giant cell arteritis in England. They found that patients were at increased risk when taking oral steroids than when they were not taking them. On the other hand, the risk elevated with low daily doses of less than 5 mg of prednisolone.

Dr. Mar Pujades-Rodriguez, Leeds Institute of Data Analytics, at the University of Leeds, United Kingdom, with coauthors said, “In periods with prescribed medication, patients’ risk was 50% higher than when it was not prescribed. Increases in risk ranged from 48% for fungal to 70% for bacterial infections.”

Among all, 56% patients had More than half of patients (22 234, 56%) had infections during 138 412 person-years of follow up, with the most common diseases being lower respiratory tract infections (27%), conjunctivitis (9%) and shingles (7%). More than one-quarter (27%) of patients were admitted to hospital, and 7% died within a week of diagnosis of infection.

Scientists noted, “Patients and clinicians should be educated about the risk of infection, need for symptom identification, prompt treatment, timely vaccination and documentation of the history of chronic infection (e.g., herpes zoster).”

The study is published in the Canadian Medical Association Journal.

- Advertisement -

Latest Updates