Skip to main content
SpringerLink
Log in

Why Can’t I Just Stay on Prednisone? The Long-Term Adverse Effects of Steroids

  • Chapter
Inflammatory Bowel Disease

Abstract

Glucocorticoids have been a mainstay of therapy for inflammatory bowel disease for many years and have proven to be very effective for inducing remission in IBD patients. However, they are fraught with many undesirable side effects that make their long-term use problematic. This chapter reviews the data behind how glucocorticoids can be effective in IBD and also reviews the many different side effects that come with both long-term and short-term usage.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Truelove SC, Witts LJ. Cortisone in ulcerative colitis. Br Med J. 1955;2:1041–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Lennard-Jones JE, Longmore AJ, Newell AC, Wilson CW, Jones FA. An assessment of prednisone, salazopyrin, and topical hydrocortisone hemisuccinate used as out-patient treatment for ulcerative colitis. Gut. 1960;1:217–22.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Summers RW, Switz DM, Sessions Jr JT, Becktel JM, Best WR, et al. National Cooperative Crohn’s Disease Study: results of drug treatment. Gastroenterology. 1979;77:847–69.

    CAS  PubMed  Google Scholar 

  4. Malchow H, Ewe K, Brandes JW, Goebell H, Ehms H, et al. European Cooperative Crohn’s Disease Study (ECCDS): results of drug treatment. Gastroenterology. 1984;86:249–66.

    CAS  PubMed  Google Scholar 

  5. Modigliani R, Mary JY, Simon JF, Cortot A, Soule JC, et al. Clinical, biological, and endoscopic picture of attacks of Crohn’s disease. Evolution on prednisolone. Groupe d’Etude Therapeutique des Affections Inflammatoires Digestives. Gastroenterology. 1990;98:811–8.

    Article  CAS  PubMed  Google Scholar 

  6. Steinhart A, Ewe K, Griffiths AM, Modigliani R, Thomsen OO. Glucocorticoids for maintenance of remission in Crohn’s disease. Cochrane Database Syst 2003;Rev 4:CD000301.

    Google Scholar 

  7. Lichtenstein GR, Feagan BG, Cohen RD, Salzberg BA, Diamond RH, et al. Serious infections and mortality in association with therapies for Crohn’s disease: TREAT registry. Clin Gastroenterol Hepatol. 2006;4:621–30.

    Article  CAS  PubMed  Google Scholar 

  8. Travis SP, Strange EF, Lémann M, Oresland T, Bemelman W, et al. European evidence-based consensus on the management of ulcerative colitis: current management. J Crohns Colitis. 2008;2:24–62.

    Article  CAS  PubMed  Google Scholar 

  9. Dignass A, European Crohn’s and Colitis Organisation (ECCO), et al. The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: current management. J Crohns Colitis. 2010;4:28–62.

    Article  CAS  PubMed  Google Scholar 

  10. Saag KG et al. Low dose long-term glucocorticoid therapy in rheumatoid arthritis: an analysis of serious adverse events. Am J Med. 1994;96(2):115–23.

    Article  CAS  PubMed  Google Scholar 

  11. Wei L, MacDonald TM, Walker BR. Taking glucocorticoids by prescription is associated with subsequent cardiovascular disease. Ann Intern Med. 2004;141(10):764–70.

    Article  PubMed  Google Scholar 

  12. Christiansen CF et al. Glucocorticoid use and risk of atrial fibrillation or flutter: a population-based, case-control study. Arch Intern Med. 2009;169(18):1677–83.

    Article  PubMed  Google Scholar 

  13. Boscaro M et al. Hypertension in Cushing’s syndrome. In: Lundecke DK, Chrousos GP, Tolis G, editors. ACTH, Cushing’s syndrome and other hypercortisolemic states. New York, NY: Raven; 1990. p. 203–10.

    Google Scholar 

  14. Whitworth JA. Mechanisms of glucocorticoid-induced hypertension. Kidney Int. 1987;31(5):1213–24.

    Article  CAS  PubMed  Google Scholar 

  15. Panthakalam S, Bhatnagar D, Klimiuk P. The prevalence and management of hyperglycaemia in patients with rheumatoid arthritis on glucocorticoid therapy. Scott Med J. 2004;49(4):139–41.

    CAS  PubMed  Google Scholar 

  16. Gurwitz JH et al. Glucocorticoids and the risk for initiation of hypoglycemic therapy. Arch Intern Med. 1994;154(1):97.

    Article  CAS  PubMed  Google Scholar 

  17. Curtis JR et al. Population‐based assessment of adverse events associated with long‐term glucocorticoid use. Arthritis Care Res. 2006;55(3):420–6.

    Article  Google Scholar 

  18. Mazziotti G et al. Glucocorticoid-induced osteoporosis: an update. Trends Endocrinol Metab. 2006;17(4):144–9.

    Article  CAS  PubMed  Google Scholar 

  19. Canalis E. Mechanisms of glucocorticoid action in bone. Curr Osteoporos Rep. 2005;3(3):98–102.

    Article  PubMed  Google Scholar 

  20. O’Brien CA et al. Glucocorticoids act directly on osteoblasts and osteocytes to induce their apoptosis and reduce bone formation and strength. Endocrinology. 2004;145(4):1835–41.

    Article  PubMed  Google Scholar 

  21. Manelli F, Giustina A. Glucocorticoid-induced osteoporosis. Trends Endocrinol Metab. 2000;11(3):79–85.

    Article  CAS  PubMed  Google Scholar 

  22. Huybers S et al. Prednisolone-induced Ca2+ malabsorption is caused by diminished expression of the epithelial Ca2+ channel TRPV6. Am J Physiol Gastrointest Liver Physiol. 2007;292(1):G92–7.

    Article  CAS  PubMed  Google Scholar 

  23. Canalis E et al. Perspectives on glucocorticoid-induced osteoporosis. Bone. 2004;34(4):593–8.

    Article  CAS  PubMed  Google Scholar 

  24. Bernstein CN, Leslie WD, Leboff MS. AGA technical review on osteoporosis in gastrointestinal diseases. Gastroenterology. 2003;124(3):795–841.

    Article  PubMed  Google Scholar 

  25. Kumagai S et al. Vertebral fracture and bone mineral density in women receiving high dose glucocorticoids for treatment of autoimmune diseases. J Rheumatol. 2005;32(5):863–9.

    CAS  PubMed  Google Scholar 

  26. Gore DC et al. Acute response of human muscle protein to catabolic hormones. Ann Surg. 1993;218(5):679.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  27. Klingenstein G et al. Inflammatory bowel disease related osteonecrosis: report of a large series with a review of the literature. Aliment Pharmacol Ther. 2005;21(3):243–9.

    Article  CAS  PubMed  Google Scholar 

  28. Messer J et al. Association of adrenoglucocorticoid therapy and peptic-ulcer disease. N Engl J Med. 1983;309(1):21–4.

    Article  CAS  PubMed  Google Scholar 

  29. Piper JM et al. Glucocorticoid use and peptic ulcer disease: role of nonsteroidal anti-inflammatory drugs. Ann Intern Med. 1991;114(9):735–40.

    Article  CAS  PubMed  Google Scholar 

  30. Starkman MN. Neuropsychiatric findings in Cushing syndrome and exogenous glucocorticoid administration. Endocrinol Metab Clin N Am. 2013;42(3):477–88.

    Article  Google Scholar 

  31. Toruner M et al. Risk factors for opportunistic infections in patients with inflammatory bowel disease. Gastroenterology. 2008;134(4):929–36.

    Article  PubMed  Google Scholar 

  32. Aberra FN et al. Glucocorticoids and immunomodulators: postoperative infectious complication risk in inflammatory bowel disease patients. Gastroenterology. 2003;125(2):320–7.

    Article  CAS  PubMed  Google Scholar 

  33. Fardet L et al. Corticosteroid‐induced clinical adverse events: frequency, risk factors and patient’s opinion. Br J Dermatol. 2007;157(1):142–8.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA

    Adam Schiro M.D. & Daniel J. Stein M.D.

Authors
  1. Adam Schiro M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniel J. Stein M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel J. Stein M.D. .

Editor information

Editors and Affiliations

  1. Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Daniel J. Stein

  2. Chief, Division Gastroenterology and Hepatology Digestive Disease Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Reza Shaker

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Schiro, A., Stein, D.J. (2015). Why Can’t I Just Stay on Prednisone? The Long-Term Adverse Effects of Steroids. In: Stein, D., Shaker, R. (eds) Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-14072-8_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-14072-8_15

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14071-1

  • Online ISBN: 978-3-319-14072-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation