Most Read Articles
01 Nov 2019
Discontinuation of antitumour necrosis factor (anti-TNF) therapy for perianal Crohn’s disease is highly likely to lead to relapse, with some patients even requiring defunctioning surgery, according to a study conducted across Asia.
Pearl Toh, 22 Oct 2019
Among patients with a large perforated peptic ulcer (PPU), undergoing omental patch repair confers comparable perioperative outcomes as gastrectomy, a retrospective local study shows.
Prof. Khean-Lee Goh, Yong Yeh Lee, 15 Oct 2019

The global community is celebrating World Stomach Day on October 2, now in its second year, and the date itself reminds us of the very first report of Helicobacter pylori in 1982.

Corticosteroid-related fractures in AIH prevented at low doses: A myth?

18 Nov 2019

Exposure to corticosteroids in patients with autoimmune hepatitis (AIH) appears to contribute to increased risks of cataract, diabetes and bone fractures, a study has found. Notably, the fracture risk is elevated at low doses, while the risk of adverse events overall is dose-dependent and is reversible.

Researchers assessed the safety of administering corticosteroid doses in the long‐term maintenance treatment of 476 AIH patients (median age at diagnosis, 44 years; 77 percent female) with a median follow‐up time of 13 years. Disease developed early (age <18 years) in 68 patients (14 percent) at a median age of 14 years.

The predominantly prescribed medications were prednisone/prednisolone (90 percent) and azathioprine (82 percent). There were 367 patients (77 percent) who were treated with the combination of prednisone/prednisolone plus azathioprine for a median of 5 years.

In the cohort, 120 patients (25 percent) developed adverse events. Binary logistic regression with a generalized estimating equation showed that low-dose prednisone/prednisolone (0.1–5.0 mg/d) was associated with higher odds of fractures, whereas higher doses (>5.0 mg/d) correlated with increased likelihood of cataracts and diabetes.

Budesonide was also found to increase the odds of cataract and fractures, and this effect was independent of prednisone/prednisolone use in the prior 1, 2 or 3 years. This finding suggests that ‘topically’ acting budesonide does not completely prevent the development of fractures or cataract and may be an independent risk factor for these adverse events, as the researchers pointed out.

Overall, the present data re‐establish the fracture risk in patients taking corticosteroids, they added. “Even low doses of [the drugs] frequently lead to substantial adverse events, refuting the assumption that [such] events are prevented by administering low doses.”

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Most Read Articles
01 Nov 2019
Discontinuation of antitumour necrosis factor (anti-TNF) therapy for perianal Crohn’s disease is highly likely to lead to relapse, with some patients even requiring defunctioning surgery, according to a study conducted across Asia.
Pearl Toh, 22 Oct 2019
Among patients with a large perforated peptic ulcer (PPU), undergoing omental patch repair confers comparable perioperative outcomes as gastrectomy, a retrospective local study shows.
Prof. Khean-Lee Goh, Yong Yeh Lee, 15 Oct 2019

The global community is celebrating World Stomach Day on October 2, now in its second year, and the date itself reminds us of the very first report of Helicobacter pylori in 1982.