Comparable Rates of Adverse Events

[Sandmason]

Here's a study, quite large, retrospective, that actually makes me less concerned about steroids versus just aging. What do you think?

pubmed.ncbi.nlm.nih.gov/287...

Comparable Rates of Glucocorticoid-Associated Adverse Events in Patients With Polymyalgia Rheumatica and Comorbidities in the General Population

There was a longer one and a discussion about it but they seem to be offline now.

There are other studies, not compared with controls, that show all the adverse events we assume are caused by long term steroid use. So many are scared of steroids, even our doctors! It's the only real treatment we have so we have to be aware, at least, and mitigate what we can, knowing we may be on prednisone for years.

[PMRpro Ambassador]

I've quoted that study quite often. What Matteson doesn't know about PMR probably isn't worth knowing.

I had PMR for 5 years before I ever got pred - and I had a lot of so-called pred adverse effects just due to PMR.

[Sandmason in reply to PMRpro]

My husband doesn't take pred and his body is falling apart faster than mine.

[PMRpro Ambassador in reply to Sandmason]

Same with mine - though he could have done with some steroids in his last year!!!

[Perigrina]

The study is interesting and helpful. 2 caveats: 1. one feature of PMR diagnosis is that people were generally fit and healthy prior to it - so the cohort may not be directly comparable. 2 many of us (as this site demonstrates) do not rely on steroids alone. Many have radically changed diets and lifestyles. An antiinflamatory diet and exercise may reduce the risk of many other diseases which the control group experienced and boosting calcium, vit D etc while on steroids my also have a preventative impact not seen in the control group.

[PMRpro Ambassador in reply to Perigrina]

Two random sets of people, age and everything else matched except having PMR or not having it seems fairly comparable - you could say the same of ANY study.

[Perigrina in reply to PMRpro]

Most research studies control for other things too - prior health, health indicators at start of study (eg blood pressure, inflamation levels etc). This study MAY have done that but it is not stated. And my second point - being the subject of a research programme or disease changes behaviour (hence the use of placebos and ensuring diet etc does not change over time). Again, this study MAY have done that but it is not stated. You would probably get similar results if your starting point was (eg) diabetes or heart attack. The diagnosis, of itself, can lead to behavioural changes or treatment that eases the condition and so reduce the risks of other diseases. My comments are not to negate the study, but to keep an open mind.

[Sandmason in reply to Perigrina]

This was totally retrospective, info gleaned only from medical records, so no one knew they were in a study at all. Quite a number of people , and no one to drop out or change behavior as it was all historical. It made me mock my former doctor though who was beyond terrified of any amount of prednisone. I couldn't escape her fast enough!

[Sandmason in reply to Perigrina]

Truly, since I had discoid lupus in my 20s, I've wondered if my basic autoimmunity hasn't protected me in some ways from other things. Why am I the only family member who never gets the flu, covid or norovirus? I had an ANA test recently, I asked for it, and it was 1:640, no pos subsets and it's meaningless. I've never been overweight though, or had high, BP, sugar, and watch my iron and dietary Ca. Who knows?

[Excelsior80]

So overall is the conclusion that effects like diabetes mellitus and bone weakening may be no more likely than normal at the pred doses used for pmr? Very reassuring if so .... and i am making lifestyle changes so should apply to me 🤞I will read properly but brain a bit non optimal right now