Arch Intern Med. Study selection Studies were selected if they provided sufficient data on patients, study design, quality, route of drug administration, end points, and analysis. 2 studies showed that final adult height in persons who used ICs in childhood was not adversely affected. 2 studies showed a strong association between high-dose, IC use and posterior subcapsular cataracts, and the review showed an association between increased risk for cataracts and IC dose, age, and ethnic origin. 1 study showed a weak association between high doses of ICs and increased risk for ocular hypertension or open-angle glaucoma.
Longitudinal studies show no effects on bone mineral density.
Commentary Lipworth's review shows that all ICs exhibit dose-dependent adverse systemic effects. Care should be taken in attempts to use these data to compare the relative systemic effects of the various ICs. The literature contains differing methods for assessment of systemic effects. For example, HPA axis effects are quantified by using many end points, ranging from spot plasma cortisol measurements and 24-hour urinary cortisol collections to serial, timed plasma cortisol assessments. All of these measures offer different sensitivities and clinical interpretability.