Systemic glucocorticoid therapy: a review of its metabolic and cardiovascular adverse events.

Abstract:

:The prevalence of use of long-term systemic glucocorticoid therapy in the general adult population is 1 %. This figure increases to up to 3 % in elderly women. Metabolic (i.e. diabetes mellitus, dyslipidemia, weight gain, lipodystrophy) and cardiovascular (i.e. hypertension, cardiovascular events) adverse events are commonly observed in these patients and can be life threatening. Paradoxically, there is very few data on some of these adverse events and many of the available studies remain inconclusive. Incidence of and risk factors for dyslipidemia, weight gain and lipodystrophy are poorly defined. The optimal treatment plan for patients diagnosed with glucocorticoid-induced diabetes or hypertension is undetermined. Finally, there is no medical consensus on the best strategies for the prevention and detection of these complications. However, certain of these questions can be answered by looking at available data on patients with endogenous hypercortisolism (i.e. Cushing's syndrome). This article reviews the pathophysiology, incidence, risk factors, screening, and treatment of glucocorticoid-induced weight gain, lipodystrophy, diabetes, dyslipidemia, hypertension, and cardiovascular events. It also focuses on the possible prevention of these adverse events by targeting the glucocorticoid receptor using selective glucocorticoid receptor modulators.

journal_name

Drugs

journal_title

Drugs

authors

Fardet L,Fève B

doi

10.1007/s40265-014-0282-9

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

1731-45

issue

15

eissn

0012-6667

issn

1179-1950

journal_volume

74

pub_type

杂志文章,评审

相关文献

DRUGS文献大全
  • Colloid volume expanders. Problems, pitfalls and possibilities.

    abstract::Colloid solutions have been developed and used over the past 70 years as expanders of the intravascular space, based on an understanding of Starling's law. Increasing osmotic pressure with colloidal products has remained an attractive theoretical premise for volume resuscitation. Indeed, colloids have been shown to in...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-199855050-00002

    authors: Roberts JS,Bratton SL

    更新日期:1998-05-01 00:00:00

  • Management of insomnia in patients with chronic obstructive pulmonary disease.

    abstract::Chronic obstructive pulmonary disease (COPD) is a common medical disorder, which causes considerable morbidity and mortality. Given the chronic and symptomatic nature of the disease, the patient is often seen in the physician's office with complaints of dyspnea. However, more than 50% of COPD patients also have sleep ...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200363040-00004

    authors: George CF,Bayliff CD

    更新日期:2003-01-01 00:00:00

  • Pomalidomide: A Review in Relapsed and Refractory Multiple Myeloma.

    abstract::Pomalidomide (Imnovid®; Pomalyst®), an analogue of thalidomide, is an immunomodulatory agent, with several mechanisms of action (both direct and indirect) thought to be involved in its anti-myeloma activity. Oral pomalidomide is available in several countries for use in combination with low-dose dexamethasone in adult...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-017-0833-y

    authors: Hoy SM

    更新日期:2017-11-01 00:00:00

  • Empagliflozin/Linagliptin: A Review in Type 2 Diabetes.

    abstract::Empagliflozin/linagliptin (Glyxambi(®)) is a once-daily sodium glucose co-transporter type 2 (SGLT2) inhibitor and dipeptidyl peptidase (DPP)-4 inhibitor fixed-dose combination product that is approved in the USA as an adjunct to diet and exercise in adults with type 2 diabetes (T2D) when treatment with both empaglifl...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-015-0457-z

    authors: Kim ES,Deeks ED

    更新日期:2015-09-01 00:00:00

  • Glipizide: a review of its pharmacological properties and therapeutic use.

    abstract::Glipizide is a 'second generation' oral hypoglycaemic agent similar in potency to glibenclamide. It is completely absorbed after oral administration and has a rapid onset of action, but the duration of its hypoglycaemic effect is shorter than that of glibenclamide. It is rapidly metabolised to inactive metabolites whi...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-197918050-00001

    authors: Brogden RN,Heel RC,Pakes GE,Speight TM,Avery GS

    更新日期:1979-11-01 00:00:00

  • Cyclo-oxygenase isoenzymes. How recent findings affect thinking about nonsteroidal anti-inflammatory drugs.

    abstract::The discovery of at least 2 cyclo-oxygenase (COX) isoenzymes, referred to as COX-1 and COX-2, has updated our knowledge of nonsteroidal anti-inflammatory drugs (NSAIDs). This has lead investigators to reconsider what can be awaited from this class of drugs. The 2 COX isoenzymes share structural and enzymatic similarit...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-199753040-00003

    authors: Jouzeau JY,Terlain B,Abid A,Nédélec E,Netter P

    更新日期:1997-04-01 00:00:00

  • Oxaliplatin. A review of its pharmacological properties and clinical efficacy in metastatic colorectal cancer and its potential in other malignancies.

    abstract:UNLABELLED:Oxaliplatin is a platinum compound that inhibits DNA synthesis, primarily by causing intrastrand cross-links in DNA. Oxaliplatin has a broad spectrum of antineoplastic activity and has demonstrated a lack of cross-resistance with other platinum compounds. In patients with metastatic colorectal cancer, intrav...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200060040-00005

    authors: Culy CR,Clemett D,Wiseman LR

    更新日期:2000-10-01 00:00:00

  • Pharmacotherapy for hepatic encephalopathy.

    abstract::Hepatic encephalopathy (HE) is a challenging clinical complication of liver dysfunction with a wide spectrum of neuropsychiatric abnormalities that range from mild disturbances in cognitive function and consciousness to coma and death. The pathogenesis of HE in cirrhosis is complex and multifactorial, but a key role i...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/10898630-000000000-00000

    authors: Phongsamran PV,Kim JW,Cupo Abbott J,Rosenblatt A

    更新日期:2010-06-18 00:00:00

  • Isradipine. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic use in cardiovascular disease.

    abstract::Isradipine, a dihydropyridine derivative, inhibits the inward calcium flux through 'slow' channels of cardiac and vascular tissue, thereby eliciting potent coronary, cerebral and peripheral vasodilatation. In comparison with other calcium channel blockers the drug offers the advantages of minimal cardiodepressant acti...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-199040010-00004

    authors: Fitton A,Benfield P

    更新日期:1990-07-01 00:00:00

  • Alipogene tiparvovec: a review of its use in adults with familial lipoprotein lipase deficiency.

    abstract::Alipogene tiparvovec (Glybera®; AMT-011, AAV1-LPL(S447X)) is an adeno-associated virus serotype 1-based gene therapy for adult patients with familial lipoprotein lipase (LPL) deficiency (LPLD) and suffering from severe or multiple pancreatitis attacks despite dietary fat restrictions. It is administered as a one-time ...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-014-0339-9

    authors: Scott LJ

    更新日期:2015-02-01 00:00:00

  • Temocillin concentrations in human tissues.

    abstract::67 samples of 15 different tissues were obtained from 26 patients who were given an intravenous bolus dose of temocillin approximately 3 to 4 hours prior to surgery. 50 tissue samples were obtained from 19 patients who received 1g temocillin and 17 tissue samples were obtained from 7 patients who received 2g temocilli...

    journal_title:Drugs

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2165/00003495-198500295-00034

    authors: Gould JG,Meikle G,Cooper DL,Horton R

    更新日期:1985-01-01 00:00:00

  • The Emerging Role of PI3K Inhibitors in the Treatment of Hematological Malignancies: Preclinical Data and Clinical Progress to Date.

    abstract::The phosphoinositide 3-kinase (PI3K)/Akt/mTOR pathway is implicated in the pathogenesis of lymphoma. Deeper understanding of the diversity and biological impact of this pathway has led to the development of specific inhibitors to this pathway. Preclinical data in cell lines, patient samples and disease models have bro...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-016-0565-4

    authors: Seiler T,Hutter G,Dreyling M

    更新日期:2016-04-01 00:00:00

  • Targeting Bruton's Tyrosine Kinase Across B-Cell Malignancies.

    abstract::Bruton's tyrosine kinase (BTK) is crucial in B-cell development and survival. The role of BTK as a downstream kinase in the B-cell receptor (BCR) signaling pathway is well described. As a key player in the pathogenesis of B-cell malignancies, targeting of dysregulated BCR signaling has been explored by development of ...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-018-1003-6

    authors: da Cunha-Bang C,Niemann CU

    更新日期:2018-11-01 00:00:00

  • Tumour necrosis factor in chronic heart failure: a peripheral view on pathogenesis, clinical manifestations and therapeutic implications.

    abstract::The development of chronic heart failure (CHF) includes phenotypic changes in a host of homeostatic systems so that, as the disease advances, CHF may be seen as a multi-system disorder with its origins in the heart but embracing many extra-cardiac manifestations. Immunological abnormalities are recognised in this cont...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200060060-00002

    authors: Bolger AP,Anker SD

    更新日期:2000-12-01 00:00:00

  • Pergolide. A review of its pharmacological properties and therapeutic potential in Parkinson's disease.

    abstract::When used to treat patients with Parkinson's disease pergolide acts at dopamine receptors in the corpus striatum to improve locomotor activity, reducing the tremor, gait disturbances, bradykinesia or akinesia and rigidity experienced by such patients. Treatment with pergolide often allows substantial reductions in con...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-199039030-00009

    authors: Langtry HD,Clissold SP

    更新日期:1990-03-01 00:00:00

  • Recent advances in the pharmacological management of pain.

    abstract::Pain is an unpleasant sensation that originates from ongoing or impending tissue damage. Management of different types of pain (acute, postoperative, inflammatory, neuropathic or cancer) is the most frequent issue encountered by clinicians and pharmacological therapy is the first line of approach for the treatment of ...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200767150-00002

    authors: Guindon J,Walczak JS,Beaulieu P

    更新日期:2007-01-01 00:00:00

  • Insulin Glargine 300 U/mL: A Review in Diabetes Mellitus.

    abstract::Insulin glargine 300 U/mL (Toujeo(®)) is a long-acting basal insulin analogue approved for the treatment of diabetes mellitus. Insulin glargine 300 U/mL has a more stable and prolonged pharmacokinetic/pharmacodynamic profile than insulin glargine 100 U/mL (Lantus(®)), with a duration of glucose-lowering activity excee...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-016-0541-z

    authors: Blair HA,Keating GM

    更新日期:2016-03-01 00:00:00

  • Gram-positive cocci infections in intensive care: guide to antibacterial selection.

    abstract::The incidence of multiresistance in Gram-positive cocci causing infections in critically ill patients admitted to the intensive care unit (ICU) has increased notably in recent years. Thus, therapeutic proposals have been modified according to the emergence of multiresistant cocci and adapted to epidemiological markers...

    journal_title:Drugs

    pub_type: 杂志文章

    doi:10.2165/00003495-200666060-00003

    authors: Alvarez-Lerma F,Grau S,Gracia-Arnillas MP

    更新日期:2006-01-01 00:00:00

  • Effect of a single dose of cefotaxime or ceftriaxone on human faecal flora. A double-blind study.

    abstract::The effect of cefotaxime and ceftriaxone on faecal flora was investigated in women undergoing routine vaginal or abdominal hysterectomy. Three groups of 9 patients received, in a double-blind fashion and just before surgery, cefotaxime 2g intravenously, ceftriaxone 2g intravenously or no antibiotic (controls). Stools ...

    journal_title:Drugs

    pub_type: 临床试验,杂志文章

    doi:10.2165/00003495-198800352-00004

    authors: Michéa-Hamzehpour M,Auckenthaler R,Kunz J,Pechère JC

    更新日期:1988-01-01 00:00:00

  • Symptomatic Efficacy of Pharmacological Treatments for Knee Osteoarthritis: A Systematic Review and a Network Meta-Analysis with a 6-Month Time Horizon.

    abstract:INTRODUCTION:Several pharmacological treatments aiming at a better symptomatic control of osteoarthritis (OA) are used in daily practice but their efficacy is often disputed. The purpose of this network meta-analysis (NMA) is to assess the efficacy on pain and function of the drugs that are most widely prescribed again...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-020-01423-8

    authors: Beaudart C,Lengelé L,Leclercq V,Geerinck A,Sanchez-Rodriguez D,Bruyère O,Reginster JY

    更新日期:2020-12-01 00:00:00

  • Advanced renal cell carcinoma: current and emerging management strategies.

    abstract::Management of renal cell carcinoma (RCC) has made considerable progress in recent years, and new emerging strategies are being developed. On the basis of the results of two randomised studies in the early 2000s, nephrectomy has now become the standard as cytoreductive surgery before embarking on systemic treatment wit...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200767090-00002

    authors: Escudier B

    更新日期:2007-01-01 00:00:00

  • European Surveillance of Antimicrobial Consumption (ESAC): value of a point-prevalence survey of antimicrobial use across Europe.

    abstract::All 27 EU member states and another seven countries participate in the European Surveillance of Antimicrobial Consumption (ESAC) project. ESAC carried out three hospital point-prevalence surveys on antimicrobial use. Point-prevalence surveys linked antimicrobial use to indication and also assessed dosing using a stand...

    journal_title:Drugs

    pub_type: 杂志文章

    doi:10.2165/11591180-000000000-00000

    authors: Zarb P,Goossens H

    更新日期:2011-04-16 00:00:00

  • Pharmacologic management of advanced cervical cancer: antiangiogenesis therapy and immunotherapeutic considerations.

    abstract::As a consequence of disparities in access to and utilization of preventative healthcare, the incidence and death rates from cervical cancer remain substantial in the face of indisputable evidence that screening saves lives. While disparities persist, there will be an urgent need for research into the treatment of adva...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-015-0481-z

    authors: Longoria TC,Tewari KS

    更新日期:2015-11-01 00:00:00

  • Phentermine and topiramate extended release (Qsymia™): first global approval.

    abstract::Vivus' proprietary oral capsule containing phentermine and extended-release (ER) topiramate has been approved in the US for the treatment of obesity. Phentermine is an appetite suppressant, while topiramate is an anti-epileptic medication. The once-daily formulation, known as Qsymia™, is designed to produce weight los...

    journal_title:Drugs

    pub_type: 杂志文章

    doi:10.2165/11640860-000000000-00000

    authors: Cameron F,Whiteside G,McKeage K

    更新日期:2012-10-22 00:00:00

  • Will abuse-deterrent formulations of opioid analgesics be successful in achieving their purpose?

    abstract::During the last 2 decades, there has been a dramatic increase in the use of strong opioids for chronic non-cancer pain. This increase has been accompanied by a steep increase in abuse, misuse, and both fatal and non-fatal overdoses involving prescription opioids. The situation is already alarming in the US. Prescripti...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/11635860-000000000-00000

    authors: Bannwarth B

    更新日期:2012-09-10 00:00:00

  • Coming to terms with nonsteroidal anti-inflammatory drug gastropathy.

    abstract::Despite well known complications, oral nonsteroidal anti-inflammatory drugs (NSAIDs) remain the most commonly prescribed medications in the US for musculoskeletal disorders such as osteoarthritis. Although there has been a recent focus on the cardiovascular and renal complications associated with these agents, NSAID g...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/11633740-000000000-00000

    authors: Roth SH

    更新日期:2012-05-07 00:00:00

  • Tipranavir: a ritonavir-boosted protease inhibitor.

    abstract::Tipranavir is a non-peptidic HIV-1 protease inhibitor. It binds strongly and selectively, has a favourable resistance profile, and is administered orally twice daily with a subtherapeutic dosage of ritonavir in a 'boosted' regimen (TPV/r) in order to increase its bioavailability. Analysis of clinical isolates from tre...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200565120-00005

    authors: Croom KF,Keam SJ

    更新日期:2005-01-01 00:00:00

  • Trimetrexate. A review of its pharmacodynamic and pharmacokinetic properties and therapeutic potential in the treatment of Pneumocystis carinii pneumonia.

    abstract::Trimetrexate is a folinic acid analogue structurally related to methotrexate, whose primary mechanism of action is believed to be inhibition of dihydrofolate reductase. This reduces the production of DNA and RNA precursors and leads to cell death. Trimetrexate is lipophilic and can passively diffuse across cell membra...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-199549040-00007

    authors: Fulton B,Wagstaff AJ,McTavish D

    更新日期:1995-04-01 00:00:00

  • Heparin Therapy: regimens and management.

    abstract::Heparin remains the most effective antithrombotic drug. It acts by combining with plasma antithrombin, thereby accelerating the neurtalisation of thrombin and other acitvated coagulation factors. Full-dose intravenous heparin is indicated in all cases of pulmonary embolism and established deep venous thrombosis, unles...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-197713010-00005

    authors: Deykin D

    更新日期:1977-01-01 00:00:00

  • Cenobamate: First Approval.

    abstract::Cenobamate (XCOPRI®) is an oral, small molecule neurotherapeutic azole compound that is being developed by SK Life Science Inc. and Arvelle Therapeutics for the treatment of epilepsy. Based on results of two pivotal phase 2 trials, cenobamate was recently approved in the USA for use in the treatment of partial-onset s...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-019-01250-6

    authors: Keam SJ

    更新日期:2020-01-01 00:00:00