Systemische Kortikosteroide bei nicht infektiöser Uveitis

Zusammenfassung

Kortikosteroide sind essenzieller Bestandteil bei der Behandlung einer nicht infektiösen Uveitis, von rheumatischen Erkrankungen, Autoimmunerkrankungen, Allergien oder bei der Behandlung oder Verhinderung einer Transplantatabstoßung. Neben den gewünschten Effekten auf das Immunsystem kann eine Langzeittherapie mit Kortikosteroiden auch zu einer ganzen Reihe von unerwünschten Wirkungen führen. Deshalb sollte die Therapie mit systemischen Kortikosteroiden in geeigneter Dosierung und mit einem ausreichenden Monitoring und einer adäquaten Prophylaxe erfolgen.

Abstract

Corticosteroids are essential in the treatment of non-infectious uveitis, rheumatic diseases, autoimmune diseases, allergy, and in the therapy and prevention of transplant rejection. In addition to their beneficial effects, corticosteroids may have various adverse events, even with long-term use. Therefore, therapy with corticosteroids necessitates adequate dosing, monitoring and prophylaxis.

Schlüsselwörter

Kortikosteroide - Uveitis - Monitoring - Osteoporoseprophylaxe - Nebenwirkungen

Key words

corticosteroids - uveitis - monitoring - osteoporosis prevention - adverse events

• Literatur

• 1 Liu D, Ahmet A, Ward L. et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy Asthma Clin Immunol 2013; 9: 30
• 2 Jabs DA, Rosenbaum JT, Foster CS. et al. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am J Ophthalmol 2000; 130: 492-513
• 3 Jabs DA. Immunosuppression for the uveitides. Ophthalmology 2018; 125: 193-202
• 4 Sellebjerg F, Nielsen HS, Frederiksen JL. et al. A randomized, controlled trial of oral high-dose methylprednisolone in acute optic neuritis. Neurology 1999; 52: 1479-1484
• 5 Wilhelm H, Schabet M. The diagnosis and treatment of optic neuritis. Dtsch Arzteblatt Int 2015; 112: 616-625 quiz 626
• 6 van Staa TP, Leufkens HGM, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int 2002; 13: 777-787
• 7 Kanis JA, Johansson H, Oden A. et al. A meta-analysis of prior corticosteroid use and fracture risk. J Bone Miner Res 2004; 19: 893-899
• 8 Huscher D, Thiele K, Gromnica-Ihle E. et al. Dose-related patterns of glucocorticoid-induced side effects. Ann Rheum Dis 2009; 68: 1119-1124
• 9 Gurwitz JH, Bohn RL, Glynn RJ. et al. Glucocorticoids and the risk for initiation of hypoglycemic therapy. Arch Intern Med 1994; 154: 97-101
• 10 Wakakura M, Song E, Ishikawa S. Corticosteroid-induced central serous chorioretinopathy. Jpn J Ophthalmol 1997; 41: 180-185
• 11 Conn HO, Poynard T. Corticosteroids and peptic ulcer: meta-analysis of adverse events during steroid therapy. J Intern Med 1994; 236: 619-632
• 12 Piper JM, Ray WA, Daugherty JR. et al. Corticosteroid use and peptic ulcer disease: role of nonsteroidal anti-inflammatory drugs. Ann Intern Med 1991; 114: 735-740
• 13 Wei L, MacDonald TM, Walker BR. Taking glucocorticoids by prescription is associated with subsequent cardiovascular disease. Ann Intern Med 2004; 141: 764-770
• 14 Souverein PC, Berard A, van Staa TP. et al. Use of oral glucocorticoids and risk of cardiovascular and cerebrovascular disease in a population based case-control study. Heart 2004; 90: 859-865
• 15 Pereira RMR, Freire de Carvalho J. Glucocorticoid-induced myopathy. Joint Bone Spine 2011; 78: 41-44
• 16 Kohsaka H. [Mechanism, diagnosis, and treatment of steroid myopathy]. Brain Nerve 2013; 65: 1375-1380
• 17 Wolkowitz OM, Burke H, Epel ES. et al. Glucocorticoids. Mood, memory, and mechanisms. Ann N Y Acad Sci 2009; 1179: 19-40
• 18 Kenna HA, Poon AW, de los Angeles CP. et al. Psychiatric complications of treatment with corticosteroids: review with case report. Psychiatry Clin Neurosci 2011; 65: 549-560
• 19 Warrington TP, Bostwick JM. Psychiatric adverse effects of corticosteroids. Mayo Clin Proc 2006; 81: 1361-1367
• 20 Stuck AE, Minder CE, Frey FJ. Risk of infectious complications in patients taking glucocorticosteroids. Rev Infect Dis 1989; 11: 954-963
• 21 Park JW, Curtis JR, Moon J. et al. Prophylactic effect of trimethoprim-sulfamethoxazole for pneumocystis pneumonia in patients with rheumatic diseases exposed to prolonged high-dose glucocorticoids. Ann Rheum Dis 2017; DOI: 10.1136/annrheumdis-2017-211796.
• 22 Lai HC, FitzSimmons SC, Allen DB. et al. Risk of persistent growth impairment after alternate-day prednisone treatment in children with cystic fibrosis. N Engl J Med 2000; 342: 851-859
• 23 Buckley L, Guyatt G, Fink HA. et al. 2017 American College of Rheumatology Guideline for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthritis Care Res 2017; 69: 1095-1110
• 24 Winthrop KL, Baddley JW. Pneumocystis and glucocorticoid use: to prophylax or not to prophylax (and when?); that is the question. Ann Rheum Dis 2018; DOI: 10.1136/annrheumdis-2017-212588.
• 25 Stern A, Green H, Paul M. et al. Prophylaxis for pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients. Cochrane Database Syst Rev 2014; (10) CD005590