Association Between Oral Corticosteroid Bursts and Severe Adverse Events

Study (n=2,623,327) found the highest rates of GI bleeding, sepsis, and heart failure occurred within the first month after initiation of steroid therapy in patients who received a single brief oral steroid burst (course length ≤14 days).

SPS commentary:

Incidence rates per 1000 person-years in steroid bursts were 27.1 (95% CI, 26.7 to 27.5) for GI bleeding, 1.5 (CI, 1.4 to 1.6) for sepsis, and 1.3 (CI, 1.2 to 1.4) for heart failure.

Authors of a related commentary explore why shorter courses may not be any better than long-term use of oral corticosteroids; highlighting rates of GI bleeding, sepsis and heart failure significantly increased within 5 to 30 days after steroid therapy initiation and attenuated during the subsequent 31 to 90 days.

Annals of Internal Medicine

Resource links:

Commentary:

https://www.acpjournals.org/doi/full/10.7326/M20-4234