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Serious adverse effects associated with glucocorticoid therapy in patients with giant cell arteritis (GCA): A nested case-control analysis

Wilson, Jessica C. and Sarsour, Khaled and Collinson, Neil and Tuckwell, Katie and Musselman, David and Klearman, Micki and Napalkov, Pavel and Jick, Susan S. and Stone, John H. and Meier, Christoph R.. (2017) Serious adverse effects associated with glucocorticoid therapy in patients with giant cell arteritis (GCA): A nested case-control analysis. Seminars in Arthritis and Rheumatism, 46 (6). pp. 819-827.

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Official URL: http://edoc.unibas.ch/59049/

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Abstract

Giant cell arteritis (GCA) is an inflammatory vasculitis preferentially affecting large and medium-sized arteries. High-dose oral glucocorticoids (GCs) are the mainstay of GCA therapy. Using data from the UK Clinical Practice Research Datalink (CPRD), we examined the risk of oral GC-related serious adverse events (SAEs) in a UK population of patients with giant cell arteritis (GCA).; We conducted a series of nested case-control analyses in GCA patients to examine the effect of increasing dose of prednisolone on the risk of developing diabetes, glaucoma, osteoporosis, fractures, serious infection requiring hospitalization, and death. We used conditional logistic regression to calculate the unadjusted and multivariate odds ratios (ORs) with 95% CIs for the associations between prednisolone use and the risks of all outcomes of interest. We stratified the analyses by increasing cumulative prednisolone use and average daily dose.; In the multivariate analyses, we observed a trend of increasing risk of diabetes and osteoporosis with increasing cumulative dose of oral prednisolone (ptrend < 0.05). GCA patients in the highest daily dose category (30mg/d) had an increased risk of diabetes (adjusted OR, 95% CI) (4.7, 2.8-7.8), osteoporosis (1.9, 1.2-2.9), fractures (2.6, 1.6-4.3), glaucoma (3.5, 2.0-6.1), serious infection (3.3, 2.2-5.2), and death (2.1, 1.3-3.5) compared to those with lower average daily prednisolone doses (5mg/d).; Compared to lower average daily prednisolone doses, high average daily doses were associated with an increased risk of serious adverse effects.
Faculties and Departments:05 Faculty of Science > Departement Pharmazeutische Wissenschaften > Pharmazie > Klinische Pharmazie/Spitalpharmazie (Meier)
UniBasel Contributors:Meier, Christoph R.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:0049-0172
e-ISSN:1532-866X
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:25 Jun 2018 08:53
Deposited On:25 Jun 2018 08:53

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