| Incidence and US Costs of Corticosteroid-Associated Adverse Events: A Systematic Literature Review. | |
| | |
MedLine Citation:
|
PMID: 21999885 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
OBJECTIVE: The objective of this systematic literature review was to evaluate the incidences and risks for adverse events (AEs) associated with oral and parenteral corticosteroids. An assessment was performed to estimate the costs of such AEs. METHODS: A systematic review of literature published from 2007 to 2009 was conducted to identify the incidence rates and risk ratios of corticosteroid-related AEs. The review protocol was developed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The literature search was expanded to include additional search terms for psychiatric conditions, infections, and peptic ulcers. Costs obtained from a separate narrative literature review were applied to AEs likely to affect third-party payers in the United States. RESULTS: A total of 357 publications were identified from the primary (n = 323) and secondary (n = 34) searches. Of these, 310 were excluded because they did not evaluate AEs related to corticosteroids, were an excluded publication type, or for other reasons. A final list of 47 studies were used for data extraction. Across patient populations, the most frequently reported corticosteroid-associated AEs were psychiatric events, infections, gastric conditions, and fractures. Corticosteroid-associated AEs reported to occur at an incidence >30% were sleep disturbances, lipodystrophy, adrenal suppression, metabolic syndrome, weight gain, and hypertension. Vertebral fractures were reported at an incidence of 21% to 30%. Dose-response relationships were documented for fractures, acute myocardial infarction, hypertension, and peptic ulcer. The costs of managing AEs that may occur with corticosteroids can be substantial. The literature reported 1-year per-patient costs of up to $26,471.80 for nonfatal myocardial infarction, and per-event costs as high as $18,357.90 for fracture. The findings from the present review should be interpreted cautiously due to several limitations, including the retrospective design of most of the studies identified, risk for confounding due to underlying disease activity or patient population, and the relatively small number of studies that reported each AE association. As this cost analysis was preliminary, a comprehensive pharmacoeconomic analysis should be undertaken to confirm the findings. CONCLUSION: Based on the findings from this review, systemic corticosteroids are a common cause of AEs that may be costly to payers. |
| | |
Authors:
|
Evelyn Sarnes; Leslie Crofford; Maria Watson; Greg Dennis; Hong Kan; Damon Bass |
Related Documents
:
|
21846415 - Coblation for epistaxis management in patients with hereditary haemorrhagic telangiecta... 21885965 - Progressive growth in epibulbar complex choristomas: report of 2 cases and review of li... 2363915 - Management of animal and human bites in the head and neck. 14962705 - Necrotic cellulitis by serratia plymuthica. 12238585 - Bordetella bronchiseptica pleural infection in a patient with aids. 21675865 - Altered stress responses in children exposed to early adversity: a systematic review of... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-10-12 |
Journal Detail:
|
Title: Clinical therapeutics Volume: - ISSN: 1879-114X ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
|
Created Date: 2011-10-17 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7706726 Medline TA: Clin Ther Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved. |
Affiliation:
|
Xcenda, Palm Harbor, Florida. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Exposure Limits: The underestimation of absorbed cell phone radiation, especially in children.
Next Document: The Perception and Pharmacokinetics of a 20-mg Dose of Escitalopram Orodispersible Tablets in a Rela...