Ulcerogenic corticosteroids – the persisting myth among Czech doctors

Česká verzia

Authors: K. Hlavová ¹; J. Martínek ¹; F. Závada ¹; M. Zavoral ¹; O. Urban ²; S. Rejchrt ³
Authors place of work: Univerzita Karlova, Interní klinika 1. LF UK a ÚVN Praha, Přednosta: plk. prof. MUDr. Miroslav Zavoral, PhD. ¹; Vítkovická nemocnice, Centrum péče o zažívací trakt, Primář: MUDr. Ondřej Urban, PhD. ²; II. interní klinika gastroenterologie FN Hradec Králové, Přednosta: prof. MUDr. Jaroslav Malý, CSc. ³
Published in the journal: Prakt. Lék. 2011; 91(12): 710-713
Category: Of different specialties

Summary

Corticosteroids were once considered highly ulcerogenic drugs. Despite the fact that many studies have not confirmed this fact, a large percentage of doctors still consider them as ulcerogenic. Even the renowned textbooks from various disciplines do not consider corticosteroids ulcerogenic except when administered with Non-Steroidal Anti-Rheumatic Agents (Non-steroidal anti-inflammatory drugs – NSAIDs). We ourselves have conducted a study in which we investigated the views of Czech doctors from various specialties and medical students on the ulcerogenicity of steroids. Not surprisingly, we have confirmed the expected – more than 80 % of the responding doctors and students consider corticosteroids to be highly ulcerogenic.

The only exception is in the field of Gastroenterology where 30 % of respondents did not consider the steroids ulcerogenic.

When comparing ulcerogenic potential of

ibuprofen,
diclofenac, and
prednisone, total of 40 % of respondents consider prednisone the most ulcerogenic.

It is obvious that despite the fact that no data prove the ulcerogenity of steroids and most modern textbooks and articles do not consider these drugs ulcerogenic, there is still a myth of the ulcerogenity of steroids in the minds of Czech doctors and students. This has undoubtedly not only important economic consequences when prescribing concomitant antisecretory prophylaxis.

Key words:
corticosteroids, ulcerogenity, peptic ulcer.

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