Navigating Prednisone Contraindications: A Call For Alternative Solutions
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Abstract
Prednisone, a synthetic corticosteroid, is widely used for managing inflammatory and autoimmune disorders such as asthma, lupus, rheumatoid arthritis, and hypersensitivity pneumonitis. However, its efficacy is overshadowed by numerous contraindications and adverse effects, necessitating the exploration of safer alternatives. Prednisone is unsuitable for individuals with conditions like liver dysfunction, heart failure, diabetes, epilepsy, osteoporosis, and glaucoma. It is also contraindicated in cases of infections, including chickenpox, shingles, and measles, and possess risks of pregnant or breastfeeding individuals. Prolonged use often results in severe complications such as adrenal insufficiency, osteoporosis, and increased infection susceptibility. Emerging therapeutic approaches aim to overcome these limitations. Non-steroidal anti-inflammatory drugs (NSAIDs) offer localized anti-inflammatory effects with fewer systemic risks, while biologics and cytokine inhibitors provide targeted immune modulation. Natural compounds, including polysaccharides from Hippophae rhamnoides L. (sea buckthorn), curcumin and resveratrol, have demonstrated anti-inflammatory properties present viable alternatives for patients unable to tolerate prednisone. Lifestyle interventions, including anti-inflammatory diets, also hold promises for reducing dependency on pharmacological agents. This review highlights the pressing need to develop and prioritize substitutes for prednisone, especially for vulnerable populations with contraindications. Particular attention is given to sea buckthorn, which have shown significant potential in modulating immune responses and reducing oxidative stress. When used in combination with adjuvant therapies such as albuterol, cetirizine, epigallocatechin gallate, and pirfenidone, these natural compounds can target multiple pathways. Bridging gap in treatment options through multidisciplinary research is crucial to mitigate the risks of prednisone and improve the quality of care for individuals with inflammatory disorders. This article underscores the urgency of innovation in corticosteroid alternatives, advocating the enhanced safety, efficacy, and accessibility in the treatment of inflammation and immune-mediated conditions.
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References
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