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Related Experiment Videos

Comparison of Systemic Corticosteroid Therapy Practices Between Pediatric and Adult Rheumatologists: A Multicenter

Övgü Özenli Yağcı1, Çisem Yıldız2, Deniz Gezgin Yıldırım2

  • 1Department of Pediatric Rheumatology, Faculty of Medicine, Gazi University, Emniyet Mahallesi, Mevlana Bulvarı, Yenimahalle, Ankara, Türkiye. ozenliovgu@gmail.com.

Rheumatology and Therapy
|June 25, 2026
PubMed
Summary

Pediatric and adult rheumatologists show significant differences in systemic corticosteroid use, including drug choice, dosing, and monitoring. This highlights the need for age-specific guidelines to standardize treatment and improve patient care.

Keywords:
Adult rheumatologyDosePediatric rheumatologyPreventive measuresSide effectsSystemic corticosteroidsTaperingVaccination practices

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Area of Science:

  • Rheumatology
  • Pharmacology
  • Clinical Practice

Background:

  • Systemic corticosteroid treatment practices may differ between pediatric rheumatologists (PRs) and adult rheumatologists (ARs).
  • Variations exist in indications, dosage, and treatment duration in daily clinical practice.
  • This study aimed to compare the practices, perceptions, and attitudes of PRs and ARs regarding systemic corticosteroid use.

Purpose of the Study:

  • To evaluate and compare the systemic corticosteroid prescribing habits of pediatric and adult rheumatologists.
  • To identify differences in drug formulation, dosing strategies, and treatment duration.
  • To assess variations in monitoring, adverse event prevention, and vaccination practices.

Main Methods:

  • An online survey was distributed to rheumatologists in Türkiye.
  • The survey assessed preferred corticosteroid formulations, dosing and tapering strategies, and monitoring for adverse effects.
  • Vaccination practices and pre-treatment evaluations were also included in the questionnaire.

Main Results:

  • Sixty PRs and 40 ARs participated; significant differences were observed in drug choice (prednisolone for PRs, methylprednisolone for ARs) and dosing (weight-based for PRs, fixed-dose for ARs).
  • PRs favored longer pulse therapy, while ARs used shorter pulses but longer bridging/maintenance therapy.
  • ARs reported delirium more frequently; PRs more commonly assessed peripheral blood smears and recommended ophthalmologic exams and specific immunizations.

Conclusions:

  • Substantial heterogeneity exists in systemic corticosteroid practices between pediatric and adult rheumatologists.
  • There is a clear need for age-specific standardized protocols for corticosteroid therapy.
  • Standardization should address dosing, preventive strategies, and complication monitoring to optimize patient outcomes.