Three percent annually on systemic glucocorticoids: facts, worries and perspectives.

A comprehensive study from Denmark established that the systemic use of glucocorticoids hormones has an annual prevalence of 3% and has been stable from 1999 to 2014. We comment on the risk of potentially long-lasting adverse effects, dependent on glucocorticoid receptor overactivation, but also mineralocorticoid receptor under-activation. We discuss the potential effects of glucocorticoid use on efficacy and toxicity of other drugs that are frequently taken concomitantly. We discuss the potential alternatives such as more selective targeting, and novel types of glucocorticoid receptor ligands. We conclude that pending improved therapies more conservative prescription of glucocorticoids may be warranted in clinical practice.