11 Dec Atopic Dermatitis: IF Used At All, Systemic Steroids Should Be Short Term Bridge To Other Therapies
MedicalResearch.com Interview with:
Dr. Jonathan Silverberg
Dr. Jonathan L. Silverberg MD PhD MPH
Assistant Professor in Dermatology
Medical Social Sciences and Preventive Medicine
Northwestern University, Chicago, Illinois
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Systemic corticosteroids are commonly used as systemic treatments for atopic dermatitis. However, few studies assessed the efficacy and safety of systemic corticosteroids in atopic dermatitis. This systematic review sought to summarize the available evidence for their use in atopic dermatitis.
Overall, 52 reviews and 12 studies were included in this systematic review. Most studies suffered from small sample size, low quality. In one of the only randomized-controlled trials performed, systemic corticosteroids were less effective than cyclosporine and led to more rebound flares. There were numerous safety and tolerability concerns with both short and long-term treatment with systemic corticosteroids. One study found that even short-term use of systemic corticosteroids was associated with increased sepsis, venous thromboembolism and fractures.
MedicalResearch.com: What should readers take away from your report?
Response: There is insufficient evidence to recommend the routine use of systemic corticosteroids in the management of atopic dermatitis. Despite the lack of supporting evidence, there is a general consensus among review articles endorsing short term use of short-courses of oral corticosteroids (<3 weeks) to interrupt acute flares, though rebound flaring is commonly observed after discontinuation. If used at all, systemic corticosteroid use should be short-term when bridging to other systemic therapies or phototherapy.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research is needed to determine the impact of systemic corticosteroids on the long-term health of patients with atopic dermatitis. The broad adverse effect profile of systemic corticosteroids highlights the need for safe and effective systemic therapies in atopic dermatitis.
Disclosures: Dr. Silverberg has been a consultant, advisory board member and investigator for Abbve, Eli Lilly, Galderma, GlaxoSmithKline, Kiniksa, Leo, Menlo, Pfizer, Realm-1, Regeneron-Sanofi, Roivant, and a speaker for Regeneron-Sanofi
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Citation:
A systematic review of safety and efficacy of systemic corticosteroids in atopic dermatitis
Yu, Sherry, Jonathan I. Silverberg, MD, PhD, MPH et al.
Journal of the American Academy of Dermatology , Volume 0 , Issue 0 ,
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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Last Updated on December 11, 2017 by Marie Benz MD FAAD