TY - JOUR
T1 - Real life safety of systemic steroids for sudden sensorineural hearing loss
T2 - a chart review
AU - Halevy, Nir
AU - Elias, Bshara
AU - Shilo, Shahaf
AU - Muhanna, Nidal
AU - Handzel, Ophir
AU - Oron, Yahav
AU - Abu Eta, Rani
AU - Ungar, Omer J.
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2022/10
Y1 - 2022/10
N2 - Objectives: To report adverse events (AEs) associated with systemic steroid treatment in idiopathic sudden sensorineural hearing loss (ISSNHL). Material and methods: A retrospective chart review of consecutive patients newly diagnosed with ISSNHL necessitating systemic steroidal treatment was conducted from 1/2017 to 2/2021. Blood pressure (BP) was monitored three times daily and morning fasting glucose was monitored once daily during treatment. An AE was defined as a fasting blood glucose level > 160 mg/dl, systolic BP > 80 mmHg, and diastolic BP > 100 mmHg. Results: In total, 143 patients were enrolled [69 (48%) males and 74 (52%) females] of whom 29 (20%) had diabetes mellitus (DM) and 46 (32%) had hypertension (HTN). The cohort’s median age (interquartile range) was 58 (37–69) years. Fifty-three patients (37%) did not complete the oral steroidal treatment due to any AE (glycemic or hypertensive). Background DM highly correlated with increased risk of a glycemic event (0.59 vs. 0.13 for diabetic and non-diabetic patients, respectively, P < 0.001). HTN correlated significantly with increased risk of an overall AE (0.54 vs. 0.29 for hypertensive and non-hypertensive patients, respectively, P = 0.001). Neither pre-treatment BP nor glucose level predicted the risk of an AE (P = 0.310 and 0.521, respectively). Conclusions: AEs due to systemic steroidal treatment are common among ISSNHL patients. Demographic and baseline values cannot predict the risk of AEs which can occur throughout the entire duration of treatment. Patients with DM and HTN are at the greatest risk of AEs. Tight blood glucose and BP monitoring are recommended during treatment. Level of evidence: 4.
AB - Objectives: To report adverse events (AEs) associated with systemic steroid treatment in idiopathic sudden sensorineural hearing loss (ISSNHL). Material and methods: A retrospective chart review of consecutive patients newly diagnosed with ISSNHL necessitating systemic steroidal treatment was conducted from 1/2017 to 2/2021. Blood pressure (BP) was monitored three times daily and morning fasting glucose was monitored once daily during treatment. An AE was defined as a fasting blood glucose level > 160 mg/dl, systolic BP > 80 mmHg, and diastolic BP > 100 mmHg. Results: In total, 143 patients were enrolled [69 (48%) males and 74 (52%) females] of whom 29 (20%) had diabetes mellitus (DM) and 46 (32%) had hypertension (HTN). The cohort’s median age (interquartile range) was 58 (37–69) years. Fifty-three patients (37%) did not complete the oral steroidal treatment due to any AE (glycemic or hypertensive). Background DM highly correlated with increased risk of a glycemic event (0.59 vs. 0.13 for diabetic and non-diabetic patients, respectively, P < 0.001). HTN correlated significantly with increased risk of an overall AE (0.54 vs. 0.29 for hypertensive and non-hypertensive patients, respectively, P = 0.001). Neither pre-treatment BP nor glucose level predicted the risk of an AE (P = 0.310 and 0.521, respectively). Conclusions: AEs due to systemic steroidal treatment are common among ISSNHL patients. Demographic and baseline values cannot predict the risk of AEs which can occur throughout the entire duration of treatment. Patients with DM and HTN are at the greatest risk of AEs. Tight blood glucose and BP monitoring are recommended during treatment. Level of evidence: 4.
KW - Idiopathic sudden sensorineural hearing loss
KW - Systemic steroids
UR - http://www.scopus.com/inward/record.url?scp=85123292882&partnerID=8YFLogxK
U2 - 10.1007/s00405-022-07264-3
DO - 10.1007/s00405-022-07264-3
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C2 - 35059792
AN - SCOPUS:85123292882
SN - 0937-4477
VL - 279
SP - 4787
EP - 4792
JO - European Archives of Oto-Rhino-Laryngology
JF - European Archives of Oto-Rhino-Laryngology
IS - 10
ER -