{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:05:08Z","timestamp":1789668308145,"version":"4.0.1"},"reference-count":43,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Oral glucocorticoids (OGCs) have a broad range of uses and are effective in treating numerous conditions. However, it is commonly acknowledged that OGCs at high doses or over long periods have a burden of toxicity. Despite the use of steroid\u2010sparing therapies, OGCs continue to be prescribed to treat a wide range of immune and inflammatory conditions. We aimed to address the following research questions: (1) what are the contemporary indications for high dose and\/or long\u2010term OGCs? (2) what patterns of use are described in the literature for high dose and\/or long\u2010term OGCs? (3) which evidence do we have for chronic conditions related to well\u2010established steroid\u2010sparing strategies and tapering regimes for OGCs? (4) what adverse effects have been reported with high dose and\/or long\u2010term OGCs?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A rapid scoping review was conducted using the Joanna Briggs Institute guidelines. The Protocol has been published on the Open Science Framework. A systematic search of MEDLINE (Sep 2014 to Sep 2024) identified systematic reviews and scoping reviews involving adults (\u2265\u200918\u2009years) treated with high doses and\/or long\u2010term OGCs for chronic inflammatory conditions. Studies involving pregnant women were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 137 reviews were included. OGCs were indicated in 47 different conditions in dermatology, respiratory, gastrointestinal, hematology, immunology, rheumatology, and other miscellaneous categories. Across all specialties, OGCs were used either at high doses (at least 20\u2009mg prednisone equivalent per day) or for long durations (for at least 3\u2009months). For types of adverse effects reported in the included reviews, 20 were labeled as endocrine, 13 as immunological, 21 as musculoskeletal, 30 as gastrointestinal, and 16 as cardiovascular. Sixty\u2010four reviews looked for\/reported unspecified adverse events. One hundred and fifteen reviews had evidence of steroid\u2010sparing\/tapering regimes, indicating the wide use of these strategies to mitigate the harmful effects of OGCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OGCs are used for a broad range of inflammatory conditions across multiple specialties. There is evidence related to a broad range of potential adverse effects across multiple body systems regardless of the indication of use. Further research is needed using a combined cross\u2010condition approach to their measurement and reduction, alongside gaining more insight into the impact of OGCs on patients' quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70233","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T07:01:09Z","timestamp":1760511669000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Mapping Use of High Dose or Long\u2010Term Oral Glucocorticoids and Steroid\u2010Sparing Strategies in Adults With Chronic Conditions: A Rapid Scoping Review of Reviews"],"prefix":"10.1002","volume":"34","author":[{"given":"Elizabeth","family":"Moore","sequence":"first","affiliation":[{"name":"School of Public Health Imperial College London  London 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