Corticosteroids as “God Drugs”: Between Therapeutic Efficacy and Side Effects

Authors

  • Elsya Jaisi Oktorra Bachelor of Nursing Study Program, Universitas Pendidikan Indonesia, Sumedang City, West Java Province, Indonesia
  • Dicka Trie Permana Bachelor of Nursing Study Program, Universitas Pendidikan Indonesia, Sumedang City, West Java Province, Indonesia
  • Revana Putri Amanda Bachelor of Nursing Study Program, Universitas Pendidikan Indonesia, Sumedang City, West Java Province, Indonesia
  • Fitriyani Fitriyani Bachelor of Nursing Study Program, Universitas Pendidikan Indonesia, Sumedang City, West Java Province, Indonesia
  • Reva Sri Puspita Bachelor of Nursing Study Program, Universitas Pendidikan Indonesia, Sumedang City, West Java Province, Indonesia
  • ⁠Siti Nurcholisa Bachelor of Nursing Study Program, Universitas Pendidikan Indonesia, Sumedang City, West Java Province, Indonesia
  • Rd. Natasya Aurellia Putri Bachelor of Nursing Study Program, Universitas Pendidikan Indonesia, Sumedang City, West Java Province, Indonesia
  • Heri Ridwan Bachelor of Nursing Study Program, Universitas Pendidikan Indonesia, Sumedang City, West Java Province, Indonesia

DOI:

https://doi.org/10.53770/amhj.v5i3.713

Keywords:

Corticosteroids, Side Effects, Benefits

Abstract

Corticosteroids are potent anti-inflammatory and immunosuppressive agents widely used in clinical practice due to their rapid therapeutic effects. Despite their proven efficacy, prolonged and inappropriate use is associated with a wide range of adverse effects affecting multiple organ systems. This systematic review aimed to evaluate the therapeutic benefits of corticosteroids and to summarize their reported side effects based on literature published between 2015 and 2025. A systematic search was conducted using Google Scholar, PubMed, and ScienceDirect with the keywords “corticosteroids,” “benefits,” and “side effects.” Eligible studies were full-text, open-access articles published in English or Indonesian. Eight articles met the inclusion criteria and were analyzed descriptively. The findings indicate that corticosteroids are effective in managing inflammatory conditions such as asthma, autoimmune diseases, atopic dermatitis, nephrotic syndrome, and postoperative inflammation. However, long-term use is associated with metabolic and endocrine disturbances (hyperglycemia and Cushing’s syndrome), musculoskeletal complications (osteoporosis and osteonecrosis), dermatological effects (skin atrophy and irritation), ocular disorders (increased intraocular pressure and glaucoma), and cardiovascular effects. Systemic corticosteroids pose the highest risk of adverse effects, while topical and ocular formulations predominantly cause local reactions but may still lead to serious complications with prolonged use. Children and older adults are particularly vulnerable. In conclusion, corticosteroids remain essential in clinical therapy, but their use must be rational, closely monitored, and supported by patient education to minimize long-term risks.

References

Ambery, P., Adamsson Eryd, S., Jenkins-Jones, S., Heywood, B., Berni, E., Brown, M. N., Astbury, C., Hunt, P., & Currie, C. J. (2022). The absolute risk of incident type 2 diabetes following exposure to systemic corticosteroids in selected steroid-related and phenotypic groups. Diabetes, Obesity and Metabolism, 24(11), 2222–2231. https://doi.org/10.1111/dom.14808

Broersen, L. H., Pereira, A. M., Jørgensen, J. O., & Dekkers, O. M. (2015). Adrenal insufficiency in corticosteroids use: Systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism, 100(6), 2171–2180. https://doi.org/10.1210/jc.2015-1218

Budiawan, E., Mariyani, M., & Lagaga, A. P. (2023). Peningkatan pengetahuan masyarakat terkait bahaya penggunaan kortikosteroid yang tidak rasional. Jurnal Malikussaleh Mengabdi, 2(1), 17–22. https://doi.org/10.29103/jmm.v2i1.10674

Compston, J. (2018). Glucocorticoid-induced osteoporosis: An update. Endocrine, 61(1), 7–16. https://doi.org/10.1007/s12020-018-1588-2

Curtis, J. R., Westfall, A. O., Allison, J., Bijlsma, J. W., Freeman, A., George, V., Kovac, S. H., Spettell, C. M., & Saag, K. G. (2006). Population-based assessment of adverse events associated with long-term glucocorticoid use. Arthritis & Rheumatism, 55(3), 420–426. https://doi.org/10.1002/art.21984

Fadhilah, N. Y., Sholih, M. G., Alya, R., & Khaerunisa, A. (2025). Analisis risiko–benefit penggunaan kortikosteroid pada penyakit asma: Literature review. Jurnal Surya Medika, 11(2), 155–161. https://doi.org/10.33084/jsm.v11i2.10533

Fadiyah, S. N., Anggraini, T. D., & Hartono. (2022). Analisis rasionalitas penggunaan kortikosteroid pada pasien asma di Rumah Sakit Universitas Sebelas Maret. Jurnal Kesehatan Kartika, 17(2), 73–78. https://doi.org/10.26874/jkkes.v17i2.239

Goodman, R. S., Johnson, D. B., & Balko, J. M. (2023). Corticosteroids and cancer immunotherapy. Clinical Cancer Research, 29(14), 2580-2587.

Hajar, T., Leshem, Y. A., Hanifin, J. M., Nedorost, S. T., Lio, P. A., Paller, A. S., Block, J., & Simpson, E. L. (2015). A systematic review of topical corticosteroid withdrawal (“steroid addiction”) in patients with atopic dermatitis and other dermatoses. Journal of the American Academy of Dermatology, 72(3), 541–549.e2. https://doi.org/10.1016/j.jaad.2014.11.024

Halim, J. G., Umboh, A., & Salendu, P. M. (2025). Efek samping kortikosteroid jangka panjang pada anak dengan sindrom nefrotik. Medical Scope Journal, 8(1), 141–145. https://doi.org/10.35790/msj.v8i1.62804

Husna, I., Ramatillah, D. L., & Anggraeni, Y. D. (2019). Evaluasi efek samping penggunaan obat tetes mata kortikosteroid pada pasien pascaoperasi di Instalasi Farmasi Rumah Sakit Mata Jakarta Eye Center Kedoya. Archives Pharmacia, 1(2), 41–51. https://doi.org/10.47007/ap.v1i2.2768

Ismail, D., Hiola, F., Salamanya, A. H., & Goni, L. (2023). Studi penggunaan kortikosteroid pada pasien dermatitis atopik di RSUD Toto Kabila Gorontalo. Jurnal Kesehatan Farmasi, 5(2), 147–157. https://doi.org/10.36086/jkpharm.v5i2.1936

Johan, R. (2015). Penggunaan kortikosteroid topikal yang tepat. Cermin Dunia Kedokteran, 42(4), 308–312. https://doi.org/10.55175/cdk.v42i4.1026

Kate, A., Shanbhag, S. S., Donthineni, P. R., Amescua, G., Quinones, V. L. P., & Basu, S. (2023). Role of topical and systemic immunosuppression in aqueous-deficient dry eye disease. Indian Journal of Ophthalmology, 71(4), 1176–1189.

Miravitlles, M., Auladell-Rispau, A., Monteagudo, M., Vázquez-Niebla, J. C., Mohammed, J., Nuñez, A., & Urrútia, G. (2021). Systematic review on long-term adverse effects of inhaled corticosteroids in the treatment of COPD. European Respiratory Review, 30(160), 210075. https://doi.org/10.1183/16000617.0075-2021

Nagesh, T. S., & Akhilesh, A. (2016). Topical steroid awareness and abuse: A prospective study among dermatology outpatients. Indian Journal of Dermatology, 61(6), 618–621. https://doi.org/10.4103/0019-5154.193666

Nugraha, I. B. A., & Gotera, W. (2025). Koinsidens insulinoma dan sindrom Cushing: Laporan kasus. Jurnal Ilmu Kesehatan Indonesia, 6(2), 168–174. https://doi.org/10.25077/jikesi.v6i2.1505

Pofi, R., Caratti, G., Ray, D. W., & Tomlinson, J. W. (2023). Treating the side effects of exogenous glucocorticoids; can we separate the good from the bad?. Endocrine Reviews, 44(6), 975-1011. https://doi.org/10.1210/endrev/bnad016

Price, M. O., Price, D. A., & Price, F. W., Jr. (2024). Long-term risk of steroid-induced ocular hypertension/glaucoma with topical prednisolone acetate 1% after Descemet stripping endothelial keratoplasty. Cornea, 43(3), 323–326. https://doi.org/10.1097/ICO.0000000000003312

Qamariat, H. (2021). Rational and irrational drug use: factors, impacts and strategies to combat irrational drug use: a narrative review. Int J Pharm Sci Clin Pharm, 2(1), 6-17.

Saleem, N., Kulkarni, A., Snow, T. A. C., Ambler, G., Singer, M., & Arulkumaran, N. (2023). Effect of corticosteroids on mortality and clinical cure in community-acquired pneumonia: a systematic review, meta-analysis, and meta-regression of randomized control trials. Chest, 163(3), 484-497. https://doi.org/10.1016/j.chest.2022.08.2229

Samuel, S., Nguyen, T., & Choi, H. A. (2017). Pharmacologic characteristics of corticosteroids. Journal of Neurocritical care, 10(2), 53-59. https://doi.org/10.18700/jnc.170035

Saini, B., Chahar, Y., Goyal, Y. K., Kumar, M., & Bandyopadhyay, A. (2019). Topical corticosteroid misuse: Observational study to evaluate pattern of abuse and adverse drug reactions. International Journal of Basic & Clinical Pharmacology, 8(9), 2064–2068. https://doi.org/10.18203/2319-2003.ijbcp20194117

Shipwright, E., & Murphy, D. (2025). Long-term adverse effects after electroconvulsive therapy (ECT): a narrative analysis exploring people’s experiences, meaning-making, and coping. Qualitative health research, 35(12), 1365-1377. https://doi.org/10.1177/10497323241303391

Stone, S., Malanga, G. A., & Capella, T. (2021). Corticosteroids: review of the history, the effectiveness, and adverse effects in the treatment of joint pain. Pain Physician, 24(S1), S233.

Suwandi, K. A., Yuliwulandari, R., & Arsyad, A. (2022). Gambaran efek samping penggunaan kortikosteroid jangka panjang pada pasien systemic lupus erythematosus (SLE). Junior Medical Journal, 1(1), 1–8. https://doi.org/10.33476/jmj.v1i1.2247

Takano, F., Ueda, K., Yamada-Nakanishi, Y., & Nakamura, M. (2025). Risk factors of pediatric steroid-induced ocular hypertension. Graefe’s Archive for Clinical and Experimental Ophthalmology, 263(3), 867–872. https://doi.org/10.1007/s00417-024-06669-6

Williams, D. M. (2018). Clinical pharmacology of corticosteroids. Respiratory care, 63(6), 655-670. https://doi.org/10.4187/respcare.06314

Yao, B., Wilson, T., Zou, R., & Orfan, N. (2025). Prevalence of three prominent corticosteroid side effects in a large asthma population by age, sex and ICD-10 asthma severity with recommendations for screening. Clinical Therapeutics, 47(9), 667–672. https://doi.org/10.1016/j.clinthera.2025.06.020

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Published

2025-12-16

How to Cite

Oktorra, E. J., Permana, D. T., Amanda, R. P., Fitriyani, F., Puspita, R. S., Nurcholisa, ⁠Siti, Putri, R. N. A., & Ridwan, H. (2025). Corticosteroids as “God Drugs”: Between Therapeutic Efficacy and Side Effects . Ahmar Metastasis Health Journal, 5(3), 156–166. https://doi.org/10.53770/amhj.v5i3.713