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Side Effect Profile of Corticosteroids

Corticosteroids may increase susceptibility to infection, mask some signs of infection and new infections may appear during their use. Suppression of the inflammatory response and immune function increases the susceptibility to fungal, viral and bacterial infections and their severity. The clinical presentation may often be atypical and may reach an advanced stage before being recognised. With increasing doses of corticosteroids, the rate of occurrence of infectious complications increases.1,2

The incidence of predictable undesirable side-effects associated with the use of corticosteroids, including hypothalamic-pituitary-adrenal suppression correlates with the relative potency of the drug, dosage, timing of administration and duration of treatment.1,2

Local Side Effects

Corticosteroids administered by intra-articular injection have been associated with local side effects, including post-injection flare (2-10%) – characterised by an increase in pain and swelling at the injection site, facial flushing (1-12%), skin atrophy (1%) and fat atrophy (1%).3

Intra-articular corticosteroids are also linked with a substantially increased risk of inflammatory response in the joint, particularly bacterial infection introduced with the injection.1,2 However, the risk of iatrogenic infection is reported to be 1 in 1,000.3

Systemic Side Effects

Systemic effects including disruption of diabetes and hypertension control, inhibition of the hypothalamic-pituitary-adrenal axis, sepsis and death may also occur.4

However, systemic complications of injectable corticosteroids are rare.5 For example, the incidence of joint sepsis following knee injections has been found to range from 1 in 3,000 to 1 in 5,000.4
Please refer to the product SPCs for full detailed information about the safety of intra-articular corticosteroid injections.

Depo-Medrone has been used in RA and OA for over 50 years

Depo-Medrone has a well-established safety and tolerability profile developed over 50 years of clinical use.1,6

References

  1. Pfizer Limited. Depo-Medrone Summary of Product Characteristics.
  2. Pfizer Limited. Depo-Medrone with Lidocaine Summary of Product Characteristics.
  3. Stephens M, et al. Am Fam Physician 2008; 78(8): 971-976.
  4. Kruse DW. Curr Rev Musculoskelet Med 2008; 1: 227-233.
  5. Cole BJ and Schumacher HR. J Am Acad Orthop Surg 2005; 13(1): 37-46.
  6. European Medicines Agency. List of European Union reference dates and frequency of submission of periodic safety reports (PSURs). Available at: https://www.ema.europa.eu/en/human-regulatory/post-authorisation/pharmacovigilance/periodic-safety-update-reports-psurs. Accessed November 2019.