Steroid Bursts and Adverse Events Save

Annals of Internal Medicine has published a population based study showing that the use of (short term) corticosteroid bursts were associated with GI bleeding, sepsis, and heart failure, often occurring within the first month of steroid therapy. 

Using Taiwans health care claims data the rates of adverse events following a single steroid burst were calculated.  Short term steroid therapy was most commonly prescribed for skin disorders and respiratory tract infections.

The incidence rates per 1000 person-years for "steroid bursts" were

• GI Bleeding - 27.1 (95% CI, 26.7 to 27.5)
• Sepsis - 1.5 (CI, 1.4 to 1.6)
• Heart Failure - 1.3 (CI, 1.2 to 1.4)

Rates of GI bleeding (IRR, 1.80 [CI, 1.75 to 1.84]), sepsis (IRR, 1.99 [CI, 1.70 to 2.32]), and heart failure (IRR, 2.37 [CI, 2.13 to 2.63]) were significantly increased in teh first 5 to 30 days after steroid therapy initiation decreased subsequently.