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A total of 2691 newly diagnosed adults with ITP between 2011 and 2018 were identified from the National Health Insurance Research Database in Taiwan, and the date of first steroid use was defined as the index date. Post\u2010index steroid use was calculated on a 90\u2010day basis as a time\u2010dependent variable and categorized by the average prednisolone\u2010equivalent daily dose (&lt;10\u2009mg vs. \u226510\u2009mg) and intensity (medication possession ratio &lt;80% vs. \u226580%). Patients were followed up for 1\u2009year from the index date for acute AE events, while chronic AEs were assessed until death, or end of 2019. Compared to patients with low\u2010dose+low\u2010intensity steroid use, those with high\u2010dose+high\u2010intensity steroid use were associated with a higher risk of acute AE (adjusted incident rate ratio [aIRR]: 1.57, 95% confidence interval [CI]: 1.38\u20131.78, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) and chronic AE (aIRR: 1.26, 95% CI: 1.08\u20131.47, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Metabolic\/endocrine and ophthalmologic disorders demonstrated the strongest correlation with a high dose and intensity. The joint effect of steroid dose and intensity was observed in patients with ITP, and the findings suggest that steroids should be used carefully.<\/jats:p>","DOI":"10.1111\/bjh.19358","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T01:23:45Z","timestamp":1709601825000},"page":"1986-1993","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Longitudinal evaluation of adverse events due to steroid use in primary immune thrombocytopenia: A population\u2010based study"],"prefix":"10.1111","volume":"204","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7908-4969","authenticated-orcid":false,"given":"Jiaan\u2010Der","family":"Wang","sequence":"first","affiliation":[{"name":"Center for Rare Disease and Hemophilia Taichung Veterans General Hospital  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan\u2010Chen","family":"Ku","sequence":"additional","affiliation":[{"name":"Novartis (Taiwan) Co., Ltd.  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Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng\u2010Yun","family":"Ku","sequence":"additional","affiliation":[{"name":"Graduate Institute of Data Science, College of Management Taipei Medical University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7593-3065","authenticated-orcid":false,"given":"Yi\u2010Ming","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Research Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"Division of Allergy, Immunology and Rheumatology Taichung Veterans General Hospital  Taichung Taiwan"},{"name":"Department of Post\u2010Baccalaureate Medicine, College of Medicine National Chung Hsing University  Taichung Taiwan"},{"name":"School of Medicine, College of Medicine National Yang Ming Chiao Tung University  Taipei 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