[Long-term glucocorticoid therapy : Is there a safe dosage?]

Area of Science:

• Pharmacology
• Immunology
• Clinical Medicine

Background:

• Glucocorticoids are widely used for chronic inflammatory diseases.
• Long-term use, especially at high doses, raises concerns about adverse effects.
• Defining conditions for safe long-term glucocorticoid treatment is crucial.

Purpose of the Study:

• To identify conditions for safe long-term glucocorticoid treatment.
• To analyze existing literature on glucocorticoid harm.
• To establish criteria for an acceptable low level of harm.

Main Methods:

• A multidisciplinary task force of medical experts and patients was formed.
• Comprehensive analysis and discussion of existing literature.
• Identification of drug and patient-specific characteristics influencing harm.

Main Results:

• The level of harm depends on drug dosage, duration, and patient-specific factors.
• Patient-specific parameters require monitoring before and during treatment.
• Optimization of patient-specific parameters is necessary for safety.

Conclusions:

• A positive benefit-risk ratio is achievable with careful management.
• Clinical practice should incorporate current knowledge and recommendations for safe glucocorticoid use.
• Individualized treatment strategies are key to minimizing harm.