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LONG-COURSE ORAL CORTICOSTEROID TOXICITY IN CHILDREN
Fahad Aljebab1, Imti Choonara1, Sharon Conroy1
1University of Nottingham.
Archives of Disease in Childhood
|August 20, 2016
Summary
Long-term oral corticosteroids in children frequently cause weight gain, Cushingoid features, and growth issues. Increased susceptibility to infection is the most serious adverse drug reaction, leading to mortality.
Area of Science:
- Pediatric pharmacology
- Drug safety
- Systematic reviews
Background:
- Oral corticosteroids are widely used for pediatric conditions like nephrotic syndrome, leukemia, and asthma.
- Adverse drug reactions (ADRs) are a known concern with prolonged corticosteroid use in children.
- This review systematically identifies common and serious ADRs and their risk levels.
Purpose of the Study:
- To identify the most frequent and serious adverse drug reactions (ADRs) associated with long-term oral corticosteroid use in children.
- To determine the relative risk levels of these identified ADRs.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (Embase, Medline, PubMed, etc.) up to March 2014.
- Studies included pediatric patients (28 days to 18 years) treated with corticosteroids for at least 15 days.
- All study types reporting clear ADR information were included.
Main Results:
- 91 studies involving 6653 children reported 4124 ADRs, primarily in leukemia, hemangioma, and asthma patients.
- Oral prednisolone was the most common corticosteroid (74%).
- Frequent ADRs included weight gain (22.4%), Cushingoid features (20.6%), and growth retardation (18.9%). Increased susceptibility to infection was the most serious ADR, causing 24 deaths.
Conclusions:
- Weight gain, Cushingoid features, and growth retardation are the most common adverse drug reactions from long-term oral corticosteroid therapy in children.
- Increased susceptibility to infection represents the most significant cause of mortality in this patient group.
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