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For that comparison, they then looked at rates of the three complications among short-term steroid users before and after they received steroids. Although many of these differences were within normal range, there were statistically significant differences between people with pre- and post-Steroid use. The rates of all three complications were about ten times higher among people who used before their first steroid treatment compared with people who used after the first steroid treatment. The rate of anaphylaxis was also twice as high, while the rate of sinusitis was four times higher. Even after adjustment for age, sex, and tobacco use, a post-Steroid-use rate of anaphylaxis was almost twice as high as pre-Steroid use. However, Dr. Wechsler said, the results show that these complications are not the same for every patient, and that there isn't anything preventing many people from getting the same treatment that they need. In addition, these rates are also higher than in the general population. About one in five people use tobacco or alcohol during their lifetime. So it's possible for a person to have a few cigarettes and drink a few beers and not have problems. The authors noted that in the general population, steroid use is relatively low, about one in 20, and a few studies have found that when steroid users are treated, the risk of these complications is lowered. There are also other complications that can occur, Dr. Wechsler said. Most doctors won't see these complications because they have no way to diagnose them. Dr. Wechsler said that there is some reason why these complications can occur. It may be that steroids prevent some cancers, or at least some other diseases from happening to steroid users. It may also be that some cancers of the kidney and spleen and prostate cannot develop in people who haven't used steroids. These complications are not very common. "The best thing a doctor can do is try and help the patient as much as possible, but do not discourage use, because it is important to reduce the risk if one is concerned about the use of any medication," she said. SOURCE: bit.ly/1C9xGm2 The New England Journal of Medicine, online January 20, 2012. Related Article: