Corticosteroids are a class of drugs that have potent anti-inflammatory and immunosuppressive properties, making them effective in the treatment of various conditions such as asthma, arthritis, and autoimmune diseases.

However, despite their therapeutic benefits, corticosteroids are associated with several drawbacks and side effects. Fortunately, there is a commonly used drug that can help reduce these drawbacks and improve the overall management of corticosteroid therapy.

Understanding corticosteroids and their drawbacks

Corticosteroids, often referred to as steroids, are synthetic drugs that closely resemble cortisol, a hormone produced by the adrenal glands.

They work by reducing inflammation, suppressing the immune system, and inhibiting the release of substances in the body that cause allergic and inflammatory responses.

While corticosteroids are highly effective in managing various medical conditions, they are associated with certain limitations and drawbacks:.

1. Adrenal suppression

Long-term use of corticosteroids can lead to adrenal suppression, a condition where the adrenal glands stop producing adequate amounts of cortisol.

This can result in adrenal insufficiency, making it difficult for the body to cope with stress or illness.

2. Osteoporosis and bone fractures

Chronic use of corticosteroids can weaken the bones, leading to a higher risk of osteoporosis and fractures. This occurs primarily due to the interference of corticosteroids with the normal bone remodeling process, resulting in decreased bone density.

3. Weight gain

Corticosteroids can cause weight gain and fluid retention due to an increased appetite and altered fluid balance in the body.

This can be particularly distressing for individuals already struggling with weight issues or those aiming for weight management.

4. Increased risk of infections

While corticosteroids suppress the immune system to reduce inflammation, they also make individuals more susceptible to infections.

This is because the immune system’s ability to fight off pathogens and infections is compromised, putting the patient at a higher risk of developing various types of infections.

5. Mood and behavioral changes

Corticosteroids can have significant psychological effects, leading to changes in mood, behavior, and sleep patterns. Some individuals may experience mood swings, irritability, anxiety, and even depression while on corticosteroid therapy.

6. Glaucoma and cataracts

Long-term use of corticosteroids, particularly in high doses, can increase the risk of developing glaucoma and cataracts. These eye conditions can cause vision impairment and may require additional treatment or surgery for management.

7. Skin thinning and easy bruising

Corticosteroids can cause thinning of the skin, making it more prone to bruising, tearing, and delayed wound healing. This side effect can be particularly concerning for individuals who are already at risk of skin-related issues.

8. Blood sugar imbalances

Corticosteroids can disrupt normal blood sugar levels and lead to steroid-induced diabetes or worsen pre-existing diabetes. This can pose challenges for individuals with diabetes who need to carefully manage their blood sugar levels.

9. Hypertension and fluid imbalances

Long-term use of corticosteroids can cause fluid imbalances and lead to hypertension (high blood pressure).

The body’s ability to regulate fluid and electrolyte balance can be disrupted, necessitating additional treatment to manage blood pressure.

10. Stunted growth in children

In children and adolescents, long-term use of corticosteroids can interfere with normal growth and development. This can lead to stunted growth, delaying the attainment of an individual’s full potential height.

A commonly used drug for reducing the drawbacks

To mitigate the drawbacks and side effects associated with corticosteroid therapy, a commonly used drug known as methotrexate is often prescribed in conjunction with corticosteroids.

Methotrexate is an immunosuppressive drug that acts by inhibiting the activity of certain immune cells. It is primarily used in the treatment of rheumatoid arthritis, psoriasis, and certain types of cancer.

When used alongside corticosteroids, methotrexate has several beneficial effects:.

1. Reduced corticosteroid dosage

Methotrexate helps lower the required dosage of corticosteroids when used in combination therapy. This is particularly important in minimizing the associated drawbacks and side effects of long-term corticosteroid use.

2. Improved disease control

Methotrexate enhances the overall control of the underlying medical condition being treated. It reduces inflammation, prevents joint damage, and suppresses overactive immune responses, resulting in better disease management.

3. Preserved adrenal function

By reducing the reliance on high doses of corticosteroids, methotrexate can help preserve adrenal function.

This lowers the risk of adrenal suppression and subsequent adrenal insufficiency, thus enhancing the body’s ability to cope with stress and illness.

4. Protection against bone loss

Methotrexate has been shown to have a positive effect on bone health. It helps prevent or minimize the bone loss associated with corticosteroid therapy, reducing the risk of osteoporosis and fractures.

5. Reduced risk of infections

Compared to corticosteroids used alone, the addition of methotrexate in therapy reduces the immunosuppressive effect of corticosteroids.

This helps lower the risk of infections, as methotrexate mainly impacts specific immune cells involved in disease progression.

6. Improved mood and behavioral changes

Studies have shown that methotrexate can improve mood and behavioral changes induced by corticosteroids. Its immunosuppressive properties may lead to a more stable psychological state by modulating the inflammatory responses in the brain.

7. Lesser incidence of eye conditions

Methotrexate may help reduce the risk of developing glaucoma and cataracts associated with long-term corticosteroid use. By allowing for lower corticosteroid doses, it reduces the overall impact on ocular health.

8. Reduced skin thinning and bruising

Methotrexate can help mitigate the effects of corticosteroids on the skin, including thinning and increased susceptibility to bruising. By enabling lower doses of corticosteroids, it minimizes the impact on skin integrity.

9. Better blood sugar control

Patients with diabetes who require corticosteroid therapy may benefit from the addition of methotrexate. It can help improve blood sugar control by reducing the doses of corticosteroids needed.

10. Normal growth in children

For children and adolescents needing long-term corticosteroid therapy, the addition of methotrexate can help mitigate the effects of stunted growth.

By reducing corticosteroid-dependent inhibition of growth, it enhances normal growth patterns in pediatric patients.

In conclusion, while corticosteroids are highly effective in managing various medical conditions, they come with several drawbacks and side effects.

To reduce these drawbacks and improve overall treatment outcomes, commonly used drugs such as methotrexate are prescribed in conjunction with corticosteroids.

Methotrexate helps reduce the required dosage of corticosteroids, improves disease control, preserves adrenal function, protects against bone loss, reduces the risk of infections, improves mood and behavioral changes, lowers the incidence of eye conditions, mitigates skin thinning and bruising, optimizes blood sugar control, and promotes normal growth in children.