Side Effects of prednisolone: A Synthesis of Findings from 8 Studies

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Original Abstract of the Article

Key Research Findings

Prednisolone is a powerful anti-inflammatory and immunosuppressive drug, but prolonged use at medium or high doses is hampered by side effects, of which metabolic side effects are most evident. 3 Research has shown that prednisolone can cause changes in gene expression and impact cell populations within the body. 3 Moreover, prednisolone has been linked to liver enlargement and muscle wasting in rats, with increased ribosomal RNA synthesis in the liver and decreased synthesis in the muscles. 8 Prednisolone also affects bone mineral density, increasing the risk of osteoporosis. 5 In rats, high doses of prednisolone have been shown to increase lipid peroxidation in the heart. 4 However, the combined use of vitamin E and selenium has demonstrated potential for mitigating these heart-related side effects. 4

Reasons for Side Effects

Prednisolone mimics the effects of cortisol, a natural steroid hormone in the body. Cortisol plays a significant role in regulating various functions including immune system suppression, inflammation, and energy metabolism. By boosting these actions of cortisol, prednisolone achieves its anti-inflammatory and immunosuppressive effects, but it also risks triggering the side effects associated with cortisol. 3

Common Side Effects

Metabolic Disturbances

Prednisolone can disrupt carbohydrate and lipid metabolism, potentially leading to side effects such as weight gain, hyperglycemia, hypertension, and high cholesterol levels. 3

Immunosuppression

Prednisolone weakens the immune system, increasing susceptibility to infections. 3 , 1

Osteoporosis

Prednisolone can decrease bone mineral density, elevating the risk of osteoporosis. 5 , 6

Gastrointestinal System

Prednisolone may cause gastrointestinal problems like gastric ulcers and peptic ulcers. 1

Psychoneurological System

Prednisolone can induce psychoneurological side effects like mood swings, insomnia, and depression. ,

Other

Other potential side effects include muscle atrophy, facial flushing, edema, hypertension, and varicella-zoster. 8 , , ,

Countermeasures for Side Effects

Metabolic Disturbances

To minimize metabolic disruptions, maintaining a healthy diet and engaging in regular moderate exercise are crucial. 3 Regular monitoring of blood sugar and blood pressure is also recommended.

Immunosuppression

To reduce the risk of immunosuppression, practicing good hygiene habits such as handwashing and gargling is vital. 3 Vaccination can also offer protection against infections.

Osteoporosis

To prevent osteoporosis, consuming adequate calcium and vitamin D is essential. 5 Regular bone density checks and appropriate treatment if needed are also vital.

Gastrointestinal System

Diet therapy or medication may be used to manage gastrointestinal issues. 1

Psychoneurological System

Counseling or drug therapy might be necessary to address psychoneurological issues. ,

Comparison Between Studies

Similarities in Studies

These studies consistently demonstrate the potential for prednisolone to cause various side effects. 3 , 1 , , 4 , , , 2 , 8 , , 5 , , , 6 , , , 7 The occurrence and severity of these side effects can be influenced by factors like the dosage of prednisolone, duration of treatment, and individual factors like age and overall health.

Differences in Studies

These studies differ in their approaches to researching prednisolone's side effects, including the specific research methods employed and the types of subjects involved. 3 , 1 , , 4 , , , 2 , 8 , , 5 , , , 6 , , , 7 This diversity in research methodologies and subject populations makes direct comparison of the results sometimes challenging.

Points to Note for Application in Daily Life

Prednisolone is a beneficial drug for treating various conditions, but understanding the associated risks of side effects is crucial. 3 , 1 , When taking prednisolone, always follow your doctor's instructions regarding dosage and duration of treatment. 3 Be vigilant for any signs of side effects and consult your doctor promptly if any occur.

Limitations of Current Research

Our understanding of prednisolone's side effects remains incomplete, with ongoing research being essential. 3 , 1 , Further investigation is necessary to deepen our understanding of the long-term consequences of prednisolone use.

Future Directions for Research

To gain a more comprehensive understanding of prednisolone's side effects, research should explore the impact of long-term prednisolone administration on gene expression and cell populations within the body. 3 Additionally, research efforts should focus on developing new treatments and preventive measures to mitigate the side effects of prednisolone.

Conclusion

Prednisolone is an effective treatment for various conditions, but it's important to acknowledge the potential side effects. 3 , 1 , If you're taking prednisolone, follow your doctor's instructions regarding dosage and treatment duration. 3 Pay attention to any potential side effects and contact your doctor if you notice anything unusual.

Literature analysis of 8 papers
Positive Content
6
Neutral Content
0
Negative Content
2
Article Type
5
0
0
0
8
1.

Clinical trial: oral prednisolone metasulfobenzoate (Predocol) vs. oral prednisolone for active ulcerative colitis.

Author: RhodesJ M, RobinsonR, BealesI, PughS, DickinsonR, DronfieldM, SpeirsC J, WilkinsonP, WilkinsonS P

Ulcerative colitis
Steroid-related side effects

Predocol 40 mg/day, a sparingly absorbed formulation of prednisolone metasulfobenzoate, was found to be as effective as conventional tapering prednisolone in treating ulcerative colitis, but with significantly fewer side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Similar efficacy of ciclesonide versus prednisolone to treat asthma worsening after steroid tapering.

Author: van den BergeM, ArshadS H, IndP W, MagnussenH, HamelmannE, KanniessF, PostmaD S

Improved asthma control
Rapid onset of action
Reduced cortisol suppression
None reported

Inhaled ciclesonide (800mug twice daily) was as effective as oral prednisolone (40mg once daily) in regaining asthma control in patients with asthma worsening, with a more rapid onset and smaller effect on cortisol suppression, suggesting a better safety profile.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Prednisolone-induced changes in gene-expression profiles in healthy volunteers.

Author: ToonenErik J M, FleurenWilco W M, NässanderUlla, van LieropMarie-José C, BauerschmidtSusanne, DokterWim H A, AlkemaWynand

Anti-inflammatory
Immunosuppressive
Metabolic side effects

Glucocorticoids (GCs) have a significant impact on gene expression and cell subpopulations, leading to both efficacy and side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Bone mineral density in relation to efficacy and side effects of budesonide and prednisolone in Crohn's disease.

Author: SchoonErik J, BollaniSimona, MillsPeter R, IsraeliEran, FelsenbergDieter, LjunghallSverker, PerssonTore, Haptén-WhiteLouise, GraffnerHans, Bianchi PorroGabriele, VatnMorten, StockbrüggerReinhold W,

Preserve bone mass
Reduce corticosteroid side effects

Budesonide treatment preserves bone mass better than prednisolone in corticosteroid-naive patients with active ileocecal Crohn's disease. Both treatments are equally effective in both corticosteroid-free and corticosteroid-dependent groups, but budesonide causes fewer corticosteroid side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

A randomised trial of differentiated prednisolone treatment in active rheumatoid arthritis. Clinical benefits and skeletal side effects.

Author: HansenM, PodenphantJ, FlorescuA, StoltenbergM, BorchA, KlugerE, SørensenS F, HansenT M

Protective effect against bone loss
Reduced disease activity
Spinal bone loss

Prednisolone treatment for rheumatoid arthritis shows mixed results. While it reduces disease activity, its effect on radiological progression is unclear. It also causes spinal bone loss, but protects against bone loss in the hand and forearm.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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