J Clin Rheumatol. 2017 Dec;23(8):416-420. doi: 10.1097/RHU.0000000000000585.
The aim of this study was to explore, from the patient's perspective, the beneficial and adverse effects (AEs) of glucocorticoids (GCs) in patients with rheumatic diseases, to be used in the development of a patient-reported outcome measure.
A cross-sectional survey, capturing benefits and AEs of GC use, was administered to 2 groups of patients: (1) those attending a tertiary rheumatology clinic with various rheumatic diseases who had used GCs within the past year and (2) patients from the Hospital for Special Surgery rheumatoid arthritis database.
Cohort 1 had 55 GC users, and cohort 2 had 95 GC users and 29 nonusers. The majority of GC users in both cohorts reported at least 1 AE (100%, 86%). The AE prevalence per person was 50% higher in cohort 1 compared with GC users in cohort 2 (7.7 vs. 5.3; AE ratio, 1.5; 95% confidence interval, 1.3-1.7) and 2-fold greater in cohort 2 GC users compared with GC nonusers (5.3 vs. 2.6; AE ratio, 2.0; 95% confidence interval, 1.6-2.6). In both cohorts, AEs identified as "worst" by GC users included skin thinning/easy bruising, sleep disturbance, mood disturbance, and change in facial shape. Most felt GCs helped their disease "a lot" (78%/62%) and that the benefits were greater than the AEs (55%/64%). Many AEs were more frequent in GC users than in nonusers.
Patients receiving GC therapy for rheumatic conditions report a large number of AEs and those that have the greatest life impact are often difficult for physicians to measure. These results will inform the development of a patient-reported outcome measure to capture the effects of GCs from the patient's perspective.
本研究旨在从患者角度探讨糖皮质激素（GCs）治疗风湿病患者的获益和不良反应（AEs），以用于开发患者报告结局（PRO）测量工具。
采用横断面调查，评估两组患者GC 使用的获益和 AEs：（1）过去 1 年内使用过 GCs 的各种风湿病患者，就诊于一家三级风湿病诊所；（2）来自特殊外科医院类风湿关节炎数据库的患者。
队列 1 有 55 名 GC 使用者，队列 2 有 95 名 GC 使用者和 29 名非使用者。两组中大多数 GC 使用者均报告至少有 1 种 AE（100%，86%）。与队列 2 的 GC 使用者相比，队列 1 中 GC 使用者的 AE 发生率高 50%（7.7 比 5.3；AE 比，1.5；95%置信区间，1.3-1.7），与队列 2 的 GC 非使用者相比，GC 使用者的 AE 发生率高 2 倍（5.3 比 2.6；AE 比，2.0；95%置信区间，1.6-2.6）。在两个队列中，GC 使用者认为“最严重”的 AEs 包括皮肤变薄/易瘀伤、睡眠障碍、情绪障碍和面部形状改变。大多数人认为 GCs 对疾病“非常有帮助”（78%/62%），且获益大于 AEs（55%/64%）。许多 AEs 在 GC 使用者中比在非使用者中更常见。
接受 GC 治疗风湿性疾病的患者报告了大量 AEs，且对生活影响最大的 AEs 往往难以被医生测量。这些结果将为开发从患者角度捕捉 GC 影响的 PRO 测量工具提供信息。
