Long-term systemic glucocorticoid therapy and weight gain: a population-based cohort study

Area of Science:

• Endocrinology
• Pharmacology
• General Practice

Background:

• Systemic glucocorticoids are widely prescribed for various conditions.
• Weight gain is a known side effect, but its extent and associated risk factors in primary care settings require further elucidation.

Purpose of the Study:

• To quantify weight gain variation in patients on long-term systemic glucocorticoids.
• To identify risk factors contributing to significant weight gain (≥10% of usual weight).

Main Methods:

• Analysis of data from The Health Improvement Network (THIN) database.
• Inclusion of 31,516 adults on systemic glucocorticoids (≥3 months, ≥10 mg/day) and 26,967 controls.
• Assessment of risk factors for weight gain ≥10% of usual weight.

Main Results:

• 39.6% of patients gained >2 kg. Younger women showed higher mean weight gain (3.6 kg vs. 2 kg in controls).
• 10.2% experienced weight gain ≥10% of usual weight.
• Risk factors included female sex, younger age, higher deprivation, smoking, higher drug dosage, and prior glucocorticoid exposure. Lower risk observed for inflammatory conditions compared to asthma/COPD.

Conclusions:

• Weight gain from systemic glucocorticoids in primary care is less substantial than often assumed, especially when accounting for usual body weight.
• Specific demographic and clinical factors increase the risk of significant weight gain.