Cumulative risk of OSC use
A cumulative dose of just 1000mg prednisolone (or equivalent) over a lifetime is enough to significantly increase the risk of most adverse events in adults. This lifetime exposure toxic threshold can be reach in just 4 typical courses of OCS for asthma exacerbations. (ref 1,2)
A cumulative dose as low as 500 mg prednisolone (or equivalent) has been associated with a significant increased risk of adverse outcomes. (ref 2,3)
Categories:
Oral corticosteroids
Entry Date:
3/2/2022
Source 1 Name:
Blakey J, et al. Oral corticosteroids stewardship for asthma in adults and adolescents: A position paper from the Thoracic Society of Australia and New Zealand. Respirology. 2021 Dec;26(12):1112-1130. doi: 10.1111/resp.14147
Source 2 Name:
Price DB, et al. Adverse outcomes from initiation of systemic corticosteroids for asthma: long-term observational study. J Asthma Allergy. 2018 Aug 29;11:193-204. doi: 10.2147/JAA.S176026.
Source 3 Name:
Skov IR, et al. Low-dose oral corticosteroids in asthma associates with increased morbidity and mortality. Eur Respir J. 2022 Sep 15;60(3):2103054. doi: 10.1183/13993003.03054-2021.