Adverse Effects and Pharmacokinetic Characteristics of High-Dose Glucocorticoid Treatment in Children with Rheumatic Diseases
Abstract
This integrated-article thesis explores the impact of long-term glucocorticoid (GC) therapy on children with RD. Long-term GC treatment is potentially associated with severe adverse drug reactions (ADRs). Our scoping review summarizes the current evidence health-related quality of life (HRQOL) impacts of this treatment on children with RD. We describe the frequency of ADRs related to long-term GC treatment in a convenience sample of pediatric RD patients on long-term prednisone therapy and evaluate clinical characteristics that may be associated with risk for of GC-related ADRs. Lastly, we present a pilot study to evaluate the feasibility of monitoring GC PK in children with RD in a prospective cohort with RD. We focus on prednisone, in particular, which is a synthetic GC used in high doses to manage moderate to severe inflammation in children with rheumatic diseases (RD). Our preliminary work demonstrates that patient factors such as baseline body-mass-index and PK variability may be associated with GC-related ADRs, which supports the need to refine our understanding of the dose-response relationship in GC treatment.