2023-12-08 08:30:36
Around 0.75% of French people received corticosteroids over a period of at least three months during the past year. Corticosteroids are medications widely used in different indications, including inflammation and allergy. What are the links between corticosteroids and immunosuppression? Health On the Net answers this question.
Corticosteroids and immunosuppression
Corticosteroids form a class of drugs widely used to treat inflammatory or allergic conditions, whether acute or chronic. They are found, for example, in the treatment of asthma, allergic rhinitis, multiple sclerosis, rheumatic diseases and even certain cancers. Derived from a hormone naturally secreted by the body, cortisone or cortisolthey are both very effective therapeutically, but also the cause of multiple side effects.
Among these side effects are immunosuppressionwhich exposes the patient on corticosteroids to a increased risk of infection. Immunosuppression corresponds to a more or less severe reduction in the capabilities of the immune system. The immunocompromised subject becomes more fragile in the face of infections. Congenital immunosuppression designates immunodepression present from birth, linked to certain genetic mutations affecting different components of the immune system. But immunosuppression can also occur later in life, this is acquired immunodepression:
- HIV infection causes immunosuppression;
- Organ transplantation requires the implementation of anti-rejection treatment responsible for immunosuppression;
- Taking certain medications called immunosuppressants or immunomodulators causes more or less severe immunosuppression.
Immunosuppression depending on corticosteroid treatment
Immunosuppression induced by certain medications exposes patients to increased risks of various infections, oral and dental infections, skin infections, ENT or respiratory infections, or even infections of the genitourinary system. These infections may be more frequent, but also more severe and/or more difficult to treat. Recent treatments for autoimmune diseases and certain cancers use immunosuppressive drugs. But the corticosteroids can also cause immunosuppression.
Does any treatment with corticosteroids expose you to immunosuppression? Corticosteroids are prescribed at different dosages, over varying durations and with different routes of administration: oral route, venous route, intra-articular route (for infiltrations for example in cases of osteoarthritis, cutaneous route or even inhaled route. Treatment with corticosteroids does not systematically expose you to immunosuppression. It all depends on the context, duration and dose administered.
The duration of treatment determines corticosteroid-induced immunosuppression
All routes of administration used for corticosteroids can cause immunosuppression. The higher the dose of corticosteroid, the greater the risk of immunosuppression.. For example, the doses administered in cancers or certain autoimmune diseases are significantly higher than those used to relieve an inflamed joint. But the most important criterion to take into account is the duration of treatment. For acute situations, for example sinusitis, treatment only lasts a few days. No risk of finding yourself immunocompromised in this context.
For longer treatments, the risk is very real, even for low doses of corticosteroids. Specialists consider that following 15 days of continuous treatment, whatever the corticosteroid prescribed and whatever the dose, there is a risk of immunosuppression, with an increased risk of infection. Among the many side effects of corticosteroids, immunosuppression is not the best known effect. However, it is essential to be informed to take the necessary precautions to protect yourself from infections during this treatment. And at the slightest suspicious symptom, you should seek advice from the pharmacist or doctor.
Read also – Dermocorticoids and sun are not contraindicated! – https://www.sante-sur-le-net.com/dermocorticoides-et-soleil-ne-sont-pas-contre-indications/
Estelle B., Doctor of Pharmacy
Sources
– Adverse effects of corticosteroids. National Cancer Institute. www.e-cancer.fr. Accessed November 27, 2023.
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