Prednisone is one of the more common corticosteroids prescribed to individuals with lupus to help reduce inflammation and decrease symptom burden. Corticosteroids are also prescribed for a number of other health issues, such as asthma, inflammatory bowel disease, and polymyalgia rheumatica. But could prescribing corticosteroids actually have negative health effects for patients? In a recent article, Medical XPress explains that researchers sought to understand whether corticosteroid exposure increased the risk of hospitalizations due to vaso-occlusive crises, a painful complication of sickle cell disease (SCD). Ultimately, while researchers did discover a correlation between corticosteroids and hospitalizations due to pain crises, they could not concretely show causation. 

To learn more about this study, take a look at the data published in Blood. 

Corticosteroids: An Overview

So what exactly are corticosteroids? Healthline describes these drugs as: 

A class of human-made or synthetic drugs [which] resemble cortisol, a hormone naturally produced by our body’s adrenal glands. [Corticosteroids] lower inflammation in the body by reducing the production of certain chemicals [and] at higher doses [can] also reduce immune system activity.

To begin, researchers sourced data from 5,151 adults with sickle cell disease from an 8-year period. Findings include:

• Individuals taking hydroxyurea had a lower risk of hospitalization due to vaso-occlusive crises. Being male and being younger in age also reduced the risk. 
• During the course of the study, 46% of patients were prescribed corticosteroids. Researchers found that the median time between prescription and hospitalization was five days.
• Corticosteroid use significantly correlated with increased hospitalization due to pain episodes. 

Again, the researchers found correlation but not quite causation. However, this research does suggest that clinicians should be more careful about providing corticosteroids to patients with sickle cell disease. Rather, in the future, clinicians should consider providing other therapies if they fit patient needs. 

About Sickle Cell Disease (SCD)

Sickle cell disease (SCD) is a group of inherited blood disorders characterized by malformed, sickle-shaped red blood cells. Defects in the gene which produces hemoglobin cause SCD. Normally, hemoglobin helps carry oxygen throughout the body. However, patients with SCD have deformed blood cells which may block blood flow. Risk factors for SCD include being of African-American descent and having a family history of this condition. Symptoms associated with SCD can include:

• Pain crises
• Jaundice (yellowing of the skin, eyes, and mucous membranes)
• Anemia (low red blood cell count)
• Fatigue
• Swelling of the hands and feet
• Organ damage
• Stroke