The risks posed by corticosteroids for people with sickle cell disease (SCD) have been highlighted in a new study.
Dr Ondine Walter, of Toulouse University Hospital in France, and colleagues evaluated the association between corticosteroids and hospitalisation for vaso-occlusive episodes (VOE).
They analysed information on 5,151 patients with at least one hospitalisation, from a French national database between 2010 and 2018.
This showed that those who used a corticosteroid were significantly more likely to be hospitalised for VOE.
The median time between filling a prescription for a corticosteroid and hospitalisation was just five days. Nearly half (46%) of patients with SCD had been prescribed at least one systemic corticosteroid during the study period – which Dr Walter believes underscores the need for widespread education about the potential risks of corticosteroids.
Further analysis suggested that those who were also taking hydroxyurea seemed to be at a reduced risk of hospitalisation.
Women were at a higher risk of admission than men, and adults were more at risk than children.
Dr Walter said: “Based on our data, corticosteroids are commonly prescribed for conditions unrelated to the underlying sickle cell disease. Vaso-occlusive events and related hospitalisation appear to follow corticosteroid prescription fairly quickly.
“This evidence suggests corticosteroids may be contributing to the events and should be avoided as much as possible in these patients.”
“Based on these results, we still need to think twice about using corticosteroids when treating patients with sickle cell disease,” said Dr Walter.
Findings were published in Blood. The team now plan to investigate the mechanism of how corticosteroids may trigger VOE.
Source: Walter O, Cougoul P, Maquet J, Bartolucci P, Lapeyre-Mestre M, Lafaurie M, Moulis G. (2022) “Risk of vaso-occlusive episode after exposure to corticosteroids in patients with sickle cell disease.” Blood, doi: 10.1182/blood.2021014473
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