Even Low-Dose Glucocorticoids Increases Risk for Serious Inf
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Even low-dose glucocorticoids (GCs) are associated with a small but significant increased risk for infection among hospitalized patients with rheumatoid arthritis (RA), a study has found.

This Retrospective cohort study aimed to quantify the risk for hospitalized infection with long-term use of low-dose glucocorticoids in patients with RA receiving stable disease-modifying antirheumatic drug (DMARD) therapy.

The study include adults with RA receiving a stable DMARD regimen for more than 6 months. Associations between glucocorticoid dose (none, less than 5 mg/d, between 5 to 10 mg/d, and greater than 10 mg/d) and hospitalized infection were evaluated using inverse probability–weighted analyses, with 1-year cumulative incidence predicted from weighted models.

Results:
-- 247297 observations were identified among 172041 patients in Medicare and 58279 observations among 44118 patients in Optum. After 6 months of stable DMARD use, 47.1% of Medicare patients and 39.5% of Optum patients were receiving glucocorticoids.
-- The 1-year cumulative incidence of hospitalized infection in Medicare patients not receiving glucocorticoids was 8.6% versus 11.0% for glucocorticoid dose of 5 mg or less per day, 14.4% for greater than 5 to 10 mg/d, and 17.7% for greater than 10 mg/d.
-- The 1-year cumulative incidence of hospitalized infection in Optum patients not receiving glucocorticoids was 4.0% versus 5.2% for glucocorticoid dose of 5 mg or less per day, 8.1% for greater than 5 to 10 mg/d, and 10.6% for greater than 10 mg/d.

Conclusively, In patients with RA receiving stable DMARD therapy, glucocorticoids were associated with a dose-dependent increase in the risk for serious infection, with small but significant risks even at doses of 5 mg or less per day. Clinicians should balance the benefits of low-dose glucocorticoids with this potential risk.

Source: https://www.acpjournals.org/doi/full/10.7326/M20-1594
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Dr. G●●●●●●●●d B●●●●●●●●●●a
Dr. G●●●●●●●●d B●●●●●●●●●●a Internal Medicine
The caveat of retrospective review... But I think the results should be reevaluated by more studies
Sep 22, 2020Like