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Glucocorticoid-associated weight gain not as bad as thought

24 Sep 2020

The amount of weight gain associated with long-term exposure to glucocorticoids is lower than usually thought, according to a study.

The study used data from the British database, The Health Improvement Network, and included 31,516 adults prescribed glucocorticoids and 26,967 nonexposed controls. Their average age was 67 years, and about 57 percent were women.

Researchers measured body weight variations for at least 3 months at a mean dose ≥10 mg/day. They found that only 12,475 (39.6 percent) individuals gained >2 kg of their usual weight during glucocorticoid exposure. Weight gain was ≥10 percent of the usual weight in 3,208 (10.2 percent) individuals.

Of note, younger women were more susceptible to weight gain. The mean weight increase in the 18–39-year-old glucocorticoid-exposed women was 3.6 kg vs 2 kg in the control group, corresponding to an absolute difference of 1.6 kg (p<0.001).

Risk factors for glucocorticoid-induced weight gain other than female sex and younger age were living in areas of higher deprivation, smoking, exposure to higher doses of the drug, and previous glucocorticoid use.

Finally, the risk of treatment-related weight gain was lower in people prescribed glucocorticoids for an inflammatory condition as opposed to those with asthma or chronic obstructive pulmonary disease.

Although more studies are needed for validation, the findings provide reassurance for patients, who consider weight gain the most worrisome glucocorticoid-induced adverse event, according to the researchers. Young and deprived women should be particularly targeted for weight gain prevention.

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