This analysis of 1.5 million insured Americans reported frequent use of short-term oral corticosteroids (7% incidence on a yearly basis). The authors note that there is in general a paucity of data on potential short-term adverse effects of corticosteroid use; their findings suggest an increased risk of sepsis, venous thromboembolism and fracture (which diminished over the subsequent 31-90 days). The risks persisted at doses of prednisolone <20mg/day or equivalent.
The authors discuss a number of limitations to their study (for example possible residual confounding; limited generalisability; focus on only specific adverse events). They conclude that greater attention to initiating prescriptions of corticosteroids and monitoring for adverse events may potentially improve patient safety; additional studies are needed to identify optimal use.