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Corticosteroids and ulcers: is there an association?
1Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh Medical Center, PA, USA.
The Annals of Pharmacotherapy
|July 1, 1996
Summary
Corticosteroids likely cause ulcers, especially with NSAIDs, high doses, or long-term use. Prophylaxis is generally unnecessary, but prudent for high-risk patients pending more research on prevention.
Area of Science:
- Gastroenterology
- Pharmacology
Background:
- Corticosteroids are widely used medications.
- Gastrointestinal (GI) ulcers are a potential adverse effect.
Purpose of the Study:
- To review the association between corticosteroid use and peptic ulcer disease (PUD).
- To identify risk factors for corticosteroid-induced ulcers.
- To evaluate the role of prophylactic therapy.
Main Methods:
- Literature review of studies examining corticosteroid use and GI ulcers.
Main Results:
- A small but probable association exists between corticosteroids and ulcers.
- High-risk patients often have concurrent NSAID use, high corticosteroid dosage (>1000 mg prednisone equivalent), prolonged duration (>30 days), or a history of PUD.
- The efficacy of prophylactic therapy is not well-established, with limited evidence from specific populations like liver transplant recipients.
Conclusions:
- Most current prophylaxis for corticosteroid-induced ulcers may be unnecessary.
- Prophylaxis is recommended for high-risk patients until further evidence is available.
- Further prospective research is needed to clarify the association and optimal prophylactic strategies.