Exposure to corticosteroids is significantly associated with increased hospitalization for Vaso-occlusive episodes (VOEs), according to a study published in France.
Sickle Cell Disease (SCD) is the most common inherited red blood cell disorder in the United States, affecting an estimated 100,000 people. This condition is marked by pain crises, also known as vaso-occlusive episodes (VOE), a major complication in patients with SCD.
The study involved 5151 patients using a case-case-time-control design of the French national health insurance database between 2010 and 2018. Everyone included in this study had at least one hospitalization for VOE. The researchers assessed the risk of hospitalization for VOE following exposure to systemic corticosteroids in patients with SCD.
According to the research, Corticosteroid exposure was significantly associated with the occurrence of hospitalizations for VOEs. The researchers also found that patients exposed to steroids had a significantly lower risk of hospitalization than unexposed patients.
“Based on our data, corticosteroids are commonly prescribed for conditions unrelated to their underlying SCD. Vaso-occlusive events and related hospitalization appear to follow corticosteroid prescription fairly quickly. This evidence suggests corticosteroids may be contributing to the events and should be avoided as much as possible in these patients.” says Ondine Walter, study author, MD, of Toulouse University Hospital in France.
In addition, the researchers found that factors such as hydroxyurea use and younger age were associated with a lower risk of hospitalization for VOE after corticosteroid exposure. The research also found that women were more likely to be hospitalized than men.
According to the study lead Dr. Walter, steroids should be used when needed and under the guidance of an SCD expert due to the potential risks of using corticosteroids.
“Corticosteroids are mostly easy to avoid, and in circumstances when they are necessary, it’s important to start them in collaboration with an SCD expert and to take all appropriate precautionary measures to administer them safely,” Walter said.
This study is limited, however, as it only shows an association between corticosteroids and VOE-related hospitalizations but does not prove a cause-and-effect relationship.