[Metabolic and cardiovascular adverse events of systemic glucocorticoid therapy]

Area of Science:

• Endocrinology
• Pharmacology

Context:

• Systemic glucocorticoid therapy is associated with numerous adverse events, including metabolic and cardiovascular complications.
• Existing data on the incidence and risk factors for glucocorticoid-induced dyslipidemia, weight gain, and lipodystrophy are limited and sometimes conflicting.
• There is a lack of consensus on the optimal management and screening strategies for these adverse events, leading to variability in clinical practice.

Purpose:

• To review and synthesize available data on the adverse events associated with systemic glucocorticoid therapy.
• To identify gaps in knowledge regarding the incidence, risk factors, and management of glucocorticoid-induced metabolic and cardiovascular complications.
• To explore the potential utility of data from patients with endogenous hypercorticism to inform understanding of glucocorticoid-induced adverse events.

Summary:

• Glucocorticoid therapy frequently leads to adverse events such as diabetes, dyslipidemia, hypertension, weight gain, lipodystrophy, and cardiovascular events.
• Key aspects like the precise incidence and risk factors for dyslipidemia, weight gain, and lipodystrophy remain incompletely understood.
• Uncertainty surrounds the optimal pharmacological treatment for glucocorticoid-induced diabetes and hypertension, and screening/prevention strategies lack standardized consensus.

Impact:

• Highlights the significant clinical burden and knowledge gaps associated with systemic glucocorticoid therapy's adverse effects.
• Underscores the need for further research to establish evidence-based guidelines for managing and preventing these complications.
• Suggests leveraging data from endogenous hypercorticism to potentially address current uncertainties in glucocorticoid-induced adverse event management.