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