Corticosteroids are widely used and very effective in treating inflammation for a wide range of conditions, but their side effects are becoming better understood. A new initiative launched jointly by the Derma Care Access Network and Arcutis Biotherapeutics, “the Corticosteroid Stewardship Alliance”, focuses on the risks of long-term exposure, encouraging clinicians and patients to use these strong medications wisely.
When corticosteroids are administered, they can impact the whole body. Common adverse effects include mood swings, cognitive challenges, insomnia and weight gain, which are usually temporary and likely to be noticed by patients. Less readily observed are gradual changes like skin atrophy, osteoporosis, high blood pressure and damage to the adrenal glands.
The new initiative aims to increase awareness of these complications from prolonged use or very potent doses of corticosteroids, and to prevent harm where possible.
When patients are given multiple corticosteroid treatments, individual prescribers may be unaware of the cumulative exposure. Serious and preventable health damage has been reported by experts across all medical specialties, who warn that complications can be overlooked, or may not be properly attributed to corticosteroid treatment.
Clear clinical guidance on these risks, as well as greater oversight and monitoring for corticosteroid prescribing, are among the recommendations the Alliance is advancing.
Monitoring Safety, Modernizing Guidance
The launch of the Corticosteroid Stewardship Alliance reflects growing interest in modernizing safety standards for these widely used medications. The group calls on federal agencies, including the Food and Drug Administration, to strengthen oversight of corticosteroid prescribing in light of long-term risks.
Corticosteroids are prescribed frequently. Over 20% of US adults were given a corticosteroid at least once during a three-year study period, most often for upper respiratory infections or spinal injury, but also for asthma, allergies, arthritis and skin conditions. While the benefits may outweigh the risks for many, especially short-term use, alternative treatments may be more suitable when long-term outcomes are considered. Reducing overall corticosteroid doses could actually protect patient health.
While corticosteroids will continue to be a go-to treatment for many conditions, their tradeoffs are well documented. Other, more targeted treatments that manage symptoms without systemic side effects should be prioritized when possible. Regulatory frameworks and clinical guidance should be updated as further safety evidence emerges.