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Steroid ( Corticosteroids or Glucocorticoids) for Arthritis May Have Higher Risk of Death

Rheumatoid arthritis can occur at any age. It usually occurs in people between 25 and 55. Women are affected more often than men.It is a chronic (long-term) disease that causes inflammation of the joints and surrounding tissues. It can also affect other organs.It is considered autoimmune disease.

RA usually affects joints on both sides of the body equally. Wrists, fingers, knees, feet, and ankles are the most commonly affected.

Corticosteroids or glucocorticoids have been used to reduce inflammation in RA for more than 40 years.However, because of potential long-term side effects, corticosteroid use is usually limited to short courses and low doses where possible. Common side effects may include bruising, psychosis, cataracts ,weight gain, susceptibility to infections, diabetes , high blood pressure , and thinning of the bones (osteoporosis ).

Glucocorticoids have potent anti-inflammatory and immunosuppressive properties. This is particularly evident when they are administered at pharmacological doses, but also is important in normal immune responses.

As a consequence, glucocorticoids are widely used as drugs to treat inflammatory conditions such as arthritis or dermatitis, and as adjunction therapy for conditions such as autoimmunediseases.Excessive glucocorticoid levels resulting from administration as a drug or
hyperadrenocorticism have effects on many systems. Some examples include inhibition of bone formation, suppression of calcium absorption (both of which can lead to osteoporosis), delayed wound healing, muscle weakness and increased risk of infection. These observations suggest a multitude of less dramatic physiologic roles for glucocorticoids.

According to a report published in the Journal of Rheumatology,even patients with rheumatoid arthritis who are treated with low-dose steroids for more than 10 years have are more likely to die than patients who are less exposed to these drugs.

In the new study, Dr. Susanna Sihvonen, of Tampere University Hospital, Finland, and colleagues analyzed death rates in 604 rheumatoid arthritis patients, whose state of health, other diseases, and arthritis severity and treatments were originally recorded in 1988. In 1999, vital status and causes of death were assessed.

The team compared mortality in 209 patients who had not received steroids, 276 who were treated with steroids for less than 10 years, and 119 patients who were treated with steroids for more than 10 years. Patients in this last group were significantly more likely to die during follow-up than those in the other groups.

The risk of death was increased by 14 percent for each year of steroid treatment and by 69 percent with treatment over 10 years compared to patients not treated with glucocorticoids.

Heart disease and stroke were the major causes of death in all groups. However, it appeared to be infections and other causes that accounted for the higher risk of death in long-term steroid users.

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