Corticosteroid therapy: a higher risk of infections

According to one study published in the Canadian Medical Association Journal, treating patients with polymyalgia rheumatica or giganto-cellular arteritis with oral corticosteroids would significantly increase the risk of infections. The study also shows that the risk of infection increases with the level of doses prescribed.

Two inflammatory diseases

On a panel of 40,000 adult patients with these two inflammatory diseases (living in England, with an average age of 73 years), the researchers observed greater risks of infections when the patients were treated with oral corticosteroid therapy than when they were not.

The treatments contained prednisolone, prednisone, hydrocortisone and cortisone. The risk of infection increased proportionally with the prescribed dose and was high even with low doses (less than 5mg of prednisolone). “In periods with treatment, patients’ risk of acquiring infections was 50% higher than when they were not prescribed anything,” says Dr Mar Pujades-Rodriguez from the University of Leeds. were 48% for fungal infections and 70% for bacterial infections.”

Promote alternative treatments

More than half of the participants contracted an infection during the study. The most common infections were lower tract respiratory infections, conjunctivitis and shingles. More than a quarter of patients were hospitalized and 7% died within a week of being diagnosed with their infection.

“Patients and caregivers should be aware of this risk of infection and the need to recognize symptoms early, seek prompt treatment, be vaccinated, and know their history of chronic infection,” advise the authors of the study. They also insist on the fact that these results on the consequences of treatment with corticosteroid therapy can be useful to public authorities in order to assess treatment alternatives to glucocorticoids for patients suffering from inflammatory diseases.