Systematic Review of the Toxicity of Long-Course Oral Corticosteroids in Children

Autor: Imti Choonara, Sharon Conroy, Fahad Aljebab
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Pediatrics
Physiology
Osteoporosis
Respiratory System Agents
Pituitary-Adrenal System
lcsh:Medicine
Cochrane Library
Weight Gain
Cohort Studies
Database and Informatics Methods
Child Development
0302 clinical medicine
Adrenal Cortex Hormones
Medicine and Health Sciences
Medicine
Case Series
030212 general & internal medicine
Database Searching
Child
Prospective cohort study
lcsh:Science
Cushing Syndrome
Multidisciplinary
Pharmaceutics
Research Assessment
Physiological Parameters
Research Design
Child
Preschool
Female
Research Article
Cohort study
medicine.medical_specialty
Child Growth
Systematic Reviews
Adolescent
Drug-Related Side Effects and Adverse Reactions
Clinical Research Design
MEDLINE
Cushingoid
CINAHL
Research and Analysis Methods
Herpes Zoster
03 medical and health sciences
Adverse Reactions
Drug Therapy
Humans
Pharmacology
Growth Restriction
business.industry
Body Weight
lcsh:R
Infant
Newborn
Biology and Life Sciences
Infant
medicine.disease
Relative risk
Chronic Disease
lcsh:Q
business
030217 neurology & neurosurgery
Zdroj: PLoS ONE, Vol 12, Iss 1, p e0170259 (2017)
PLoS ONE
ISSN: 1932-6203
Popis: Background Long courses of oral corticosteroids are commonly used in children in the management of chronic conditions. Various adverse drug reactions (ADRs) are known to occur with their use. This systematic review aimed to identify the most common and serious ADRs and to determine their relative risk levels. Methods A literature search of Embase, Medline, International Pharmaceutical Abstracts, CINAHL, Cochrane Library and PubMed was performed with no language restrictions in order to identify studies where oral corticosteroids were administered to patients aged 28 days to 18 years of age for at least 15 days of treatment. Each database was searched from their earliest dates to January 2016. All studies providing clear information on ADRs were included. Results One hundred and one studies including 33 prospective cohort studies; 21 randomised controlled trials; 21 case series and 26 case reports met the inclusion criteria. These involved 6817 children and reported 4321 ADRs. The three ADRs experienced by the highest number of patients were weight gain, growth retardation and Cushingoid features with respective incidence rates of 21.1%, 18.1% and 19.4% of patients assessed for these ADRs. 21.5% of patients measured showed decreased bone density and 0.8% of patients showed osteoporosis. Biochemical HPA axis suppression was detected in 269 of 487 patients where it was measured. Infection was the most serious ADR, with twenty one deaths. Varicella zoster was the most frequent infection (9 deaths). Conclusions Weight gain, growth retardation and Cushingoid features were the most frequent ADRs seen when long-course oral corticosteroids were given to children. Increased susceptibility to infection was the most serious ADR.
Databáze: OpenAIRE
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