A nationwide German study found that prolonged use of systemic glucocorticosteroids (SGCs) in atopic dermatitis patients leads to a significantly higher risk of multiple adverse events. The research, based on statutory health insurance data, revealed that longer treatment duration-more than the cumulative dose-is the primary driver of complications.
Each additional three months of SGC therapy increased the hazard ratios for various conditions: mental health disorders (1.21), gastritis or duodenitis (1.07), osteoporosis (1.37), hypertension (1.26), and diabetes mellitus (1.35). This suggests that even modest extensions in treatment duration elevate risks substantially.
The findings reinforce current guidelines that systemic glucocorticosteroids should be limited to short-term relief of severe AD flares. For patients requiring ongoing systemic therapy, alternative treatments offer safer long-term management. Clinicians are urged to monitor patients closely and consider the cumulative time on steroids when assessing risk.