According to a study, small amounts of cortisone have less of an impact on the blood pressure and weight of rheumatism patients than is often feared, even when taken over a longer period of time.
Patients who received such therapy for two years gained an average of a kilo more than patients who were not treated with it, researchers report in the journal "Annals of Internal Medicine". There was no effect on blood pressure. However, cortisone can also have a number of other side effects that were not examined here.
The scientists from the Charité in Berlin, among others, analyzed data from a total of more than 1,100 people with rheumatoid arthritis from five previous studies. The authors of the study write that there can undoubtedly be various side effects with medium to high doses of cortisone. The term cortisone is often used colloquially to represent substances that mimic the effects of cortisol or cortisone. Experts also speak of the group of glucocorticoids. Such preparations are used, inter alia, against inflammatory diseases.
Less amount of cortisone is used today
Because cortisone preparations "help so well against rheumatoid arthritis, 30 to 50 percent of those affected still take them two years after diagnosis - contrary to current medical guidelines and recommendations," said first author Andriko Palmowski in a Charité statement. However, insights into many side effects often came from earlier times when higher doses were more common. For the smaller amounts used today, the data are less clear, it said. For the analysis, the team specifically focused on completed work with particularly high-quality methodology: In so-called randomized controlled studies, subjects are randomly assigned to groups that receive either a drug or a placebo. The results are then compared.
"The results of our study do not make the guidelines obsolete, because glucocorticoids can also have other serious side effects such as osteoporosis, diabetes, cardiovascular diseases or a tendency to infections," said study leader Frank Buttgereit (Charité) according to the announcement. For many rheumatism patients and their doctors, however, concerns about an increase in blood pressure and weight gain are important decision-making criteria. According to the analysis, however, they were not of great relevance. "Instead, decision-making should focus more on the other side effects," says Buttgereit.
The Institute for Quality and Efficiency in Health Care (IQWiG) states on an information website about cortisone in general that the fear of cortisone treatment is still widespread today. "However, it is often based on misconceptions or misinformation." With the right dose and not taking it for too long, the risk of side effects is lower than most people think. However, risks and side effects also depended on the dosage form. Tablets would have significantly stronger side effects than creams, especially if taken for a longer period of time.