More than 90 days of oral steroids tied to higher AE risk in atopic dermatitis

The use of oral corticosteroids for more than 90 days among individuals with atopic dermatitis (AD) appears to be associated with a slight increase in the risk of adverse events (AEs), according to a study.

Researchers performed a nested case-control study and used data from the Health Insurance Review and Assessment Service database of South Korea. They looked at a population of 1,025,270 AD patients to measure the risk of 11 AEs—osteoporosis, fracture, type 2 diabetes, hyperlipidemia, hypertension, myocardial infarction, stroke, heart failure, avascular necrosis, cataract, or glaucoma.

The analysis included 164,809 AD patients (mean age 39.4 years, 56.9 percent women) who had a diagnosis of any of the 11 AEs and 328,303 matched controls (mean age 39.3 years, 56.9 percent women) who had never received a diagnosis of any of the 11 AEs. Long-term use of oral corticosteroids was defined as cumulative supply of more than 30 days or more than 90 days of oral corticosteroid prescription per year.

A total of 5,533 patients (3.4 percent) in the case group and 10,561 of those (3.2 percent) in the control group were exposed to oral corticosteroids for more than 30 days. The number of patients exposed to oral corticosteroids for more than 90 days were 684 (0.4 percent) and 1,153 (0.4 percent) in the respective groups.

Multivariable conditional logistic regression analyses showed that the use of oral corticosteroids for more than 30 days did not contribute to an increased risk of AEs (adjusted odds ratio [aOR], 1.00, 95 percent confidence interval [CI], 0.97–1.04). However, use of oral corticosteroids for more than 90 days was associated with a small risk increase (aOR, 1.11, 95 percent CI, 1.01–1.23), with the risk increasing for each cumulative or consecutive year of long-term use.