Prolonged oral glucocorticoid therapy is particularly prevalent in older adults, and these patients are vulnerable to the varied complications of this treatment. Care must be taken to use the lowest possible dose and the shortest duration of therapy.
Use of oral glucocorticoid therapy is widespread in our community for the treatment of inflammatory and autoimmune conditions, but is complicated by the significant side effects of these drugs. Although the most common indication for oral glucocorticoid therapy is respiratory disease, especially chronic obstructive pulmonary disease (COPD), rheumatological diseases are the leading indication for prolonged therapy (see the box on page 60).
Older adults and the elderly have the highest usage of oral glucocorticoids and are vulnerable to myriad complications. Most complications are directly related to the dose and duration of therapy.