A large systematic review and meta-analysis has found that short courses of systemic corticosteroids (≤14 days) in children are associated with a small but significant increased risk of adverse effects, including hyperglycemia and sleep disturbances.
Published in JAMA Network Open, the study analyzed data from 45 randomized clinical trials involving 6,470 children (mean age 5.6 years). The results showed:
- 38 more cases of hyperglycemia and
- 15 more sleep disturbances
per 1,000 patients treated with corticosteroids, compared to controls.
There was low-certainty evidence suggesting a slight increase in gastrointestinal bleeding (13 more cases per 1,000), though serious adverse events or discontinuation due to side effects were not significantly linked to corticosteroid use.
Lead author Dr. Joao Pedro Lima (McMaster University, Canada) emphasized that while corticosteroids are often necessary, clinicians should be aware that “even short-term use is not risk-free.” Fortunately, most side effects were mild and not serious.
The study highlights the need for careful monitoring when prescribing corticosteroids to children and better reporting of adverse events in clinical trials.
