Corticosteroids, synthetic analogues of the natural steroid hormones produced by the adrenal cortex, are substances which feature an anti-inflammatory and immunosuppressive action and are indicated for various allergies, rheumatic diseases, autoimmune diseases, etc.
They are extremely effective drugs, with a high therapeutic value, but they can also have side effects—sometimes serious ones—on the various organs and systems. The side effects of corticosteroids are tied to the physiological actions that these hormones exert in the body and include hypertension, hyperglycaemia and diabetes, truncal obesity, osteoporosis and cataracts.
Issues related to tolerability are particularly relevant for certain patient populations undergoing long-term treatment with corticosteroids. These include children and adolescents, for whom treatment with steroids may cause restricted growth and behavioural problems; the elderly, for whom the treatment may lead to bone loss and fractures; and diabetic patients, whose glycaemic control may be altered by corticosteroids.
Many corticosteroids are available on the market, differing in the strength of their anti-inflammatory powers, the specificity of their anti-inflammatory effect, the length of their action, and their safety and tolerability profiles.
The doses of corticosteroids used in clinical practice vary widely, depending on the condition being treated and its severity.