For what conditions?
Many diseases are treated with corticosteroids. It would be difficult to include all of them on a single list. For example, when prednisoneentered the market, it concerned the treatment of over a hundred diseases.
A study in the UK revealed that the main conditions frequently requiering long term (i.e. > 3 months) prescriptions of oral corticosteroid over the past 20 years were:
| Period 1990 – 2008 | |
|---|---|
| Asthma | 25 – 30% of prescriptions |
| Polymyalgia rheumatica/ giant cell arteritis | 15 – 20% of prescriptions |
| Chronic obstructive pulmonary disease | 15 – 20% of prescriptions |
| Rheumatoid arthritis | 5% of prescriptions |
| Cancer | 5% of prescriptions |
| Eczema/ atopic dermatitis/ pruritus | 5% of prescriptions |
| Other skin diseases | 5% of prescriptions |
| Crohn’s disease | 3% of prescriptions |
| Ulcerative colitis | 3% of prescriptions |
| Transplantation | less than 2% of prescriptions |
| Connective tissue (e.g. systemic lupus) | less than 2% of prescriptions |
| Sarcoidosis | less than 1% of prescriptions |
| Addison’s disease | less than 1% of prescriptions |
| Other vasculitis (e.g. Wegener’s granulomatosis) | less than 1% of prescriptions |
| Myasthenia | less than 1% of prescriptions |
| Kidney disease | less than 1% of prescriptions |
The same study showed that the main indications of short-term corticosteroid treatment were:
| Period 1990 – 2008 | |
|---|---|
| Bronchopulmonary and ENT diseases E.g. asthma, bronchopulmonary infections, chronic obstructive pulmonary disease, nasopharyngitis, laryngitis, sinusitis |
~ 40% of prescriptions |
| Rheumatological and neurological diseases E.g. facial paralysis, polymyalgia rheumatica, temporal arteritis, rheumatoid arthritis, multiple sclerosis |
5 – 10% of prescriptions |
| Gastrointestinal diseases E.g. mouth ulcers, Crohn’s disease, ulcerative colitis |
~ 5% of prescriptions |
| Dermatological diseases E.g. hives, eczema |
less than 5% of prescriptions |
| Other diseases, e.g. cancer, kidney disease | ~ 30% of prescriptions |
| Unknown reason for prescription | 10 – 15% of prescriptions |
Useful references
- Fardet L et al. Description des prescriptions de corticothérapies orales en population générale. Rev Med Interne. 2011
- Gudbjornsson B et al. Prevalence of long term steroid treatment and the frequency of decision making to prevent steroid induced osteoporosis in daily clinical practice. Ann Rheum Dis. 2002
- Walsh LJ et al. Use of oral corticosteroids in the community and the prevention of secondary osteoporosis: a cross sectional study. BMJ. 1996
- van Staa TP et al. Use of oral corticosteroids in the United Kingdom. QJM. 2000