Treating the Side Effects of Exogenous Glucocorticoids; Can We Separate the Good From the Bad?
Level 5 - mechanism / opinion, no new human data
Narrative review of mechanisms and therapeutic strategies with no systematic search or new human trial data
PubMed 37253115 · doi:10.1210/endrev/bnad016
What was done
The authors reviewed the adverse effect profile associated with exogenous systemic and topical glucocorticoid use (e.g., central weight gain, hypertension, insulin resistance, type 2 diabetes, osteoporosis) and evaluated pharmacological strategies to mitigate these toxicities while maintaining anti-inflammatory efficacy, including licensed co-prescriptions, selective glucocorticoid receptor agonists/modulators, and 11β-hydroxysteroid dehydrogenase targeting.
What was found
The abstract reports that an estimated 2% to 3% of the general population is prescribed systemic or topical glucocorticoids. No other numerical findings, trial outcomes, or effect sizes are provided. The authors note that prevention data for existing drug co-prescriptions remain limited, selective receptor modulators are ongoing in clinical trials, and tissue-specific metabolic targeting shows early potential with limited clinical trial data.
Why it matters
Glucocorticoid-induced adverse effects present substantial clinical and economic burdens. Clarifying strategies to separate anti-inflammatory efficacy from metabolic and skeletal toxicity addresses a major unmet need in long-term steroid management.
Limits
This is a narrative review without systematic search protocols, meta-analytic data, or novel empirical findings. The abstract provides no quantitative comparative efficacy, safety endpoints, or specific trial metrics.
Cited by
- supports Prescribed corticosteroids promote rapid weight gain and insulin resistance by activating the glucocorticoid stress pathway.