ArticlePharmacoepidemiology and drug safety2025
Mapping Use of High Dose or Long-Term Oral Glucocorticoids and Steroid-Sparing Strategies in Adults With Chronic Conditions: A Rapid Scoping Review of Reviews.
Article in Pharmacoepidemiology and drug safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Mapping Use of High Dose or Long-Term Oral Glucocorticoids and Steroid-Sparing Strategies in Adults With Chronic Conditions: A Rapid Scoping Review of Reviews.Pharmacoepidemiology and drug safety · 2025Article
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Authors and funding
14 authors.
Funding
Abstract
purposeOral glucocorticoids (OGCs) have a broad range of uses and are effective in treating numerous conditions. However, it is commonly acknowledged that OGCs at high doses or over long periods have a burden of toxicity. Despite the use of steroid-sparing therapies, OGCs continue to be prescribed to treat a wide range of immune and inflammatory conditions. We aimed to address the following research questions: (1) what are the contemporary indications for high dose and/or long-term OGCs? (2) what patterns of use are described in the literature for high dose and/or long-term OGCs? (3) which evidence do we have for chronic conditions related to well-established steroid-sparing strategies and tapering regimes for OGCs? (4) what adverse effects have been reported with high dose and/or long-term OGCs?
methodsA rapid scoping review was conducted using the Joanna Briggs Institute guidelines. The Protocol has been published on the Open Science Framework. A systematic search of MEDLINE (Sep 2014 to Sep 2024) identified systematic reviews and scoping reviews involving adults (≥ 18 years) treated with high doses and/or long-term OGCs for chronic inflammatory conditions. Studies involving pregnant women were excluded.
resultsIn total, 137 reviews were included. OGCs were indicated in 47 different conditions in dermatology, respiratory, gastrointestinal, hematology, immunology, rheumatology, and other miscellaneous categories. Across all specialties, OGCs were used either at high doses (at least 20 mg prednisone equivalent per day) or for long durations (for at least 3 months). For types of adverse effects reported in the included reviews, 20 were labeled as endocrine, 13 as immunological, 21 as musculoskeletal, 30 as gastrointestinal, and 16 as cardiovascular. Sixty-four reviews looked for/reported unspecified adverse events. One hundred and fifteen reviews had evidence of steroid-sparing/tapering regimes, indicating the wide use of these strategies to mitigate the harmful effects of OGCs.
conclusionOGCs are used for a broad range of inflammatory conditions across multiple specialties. There is evidence related to a broad range of potential adverse effects across multiple body systems regardless of the indication of use. Further research is needed using a combined cross-condition approach to their measurement and reduction, alongside gaining more insight into the impact of OGCs on patients' quality of life.
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