Steroid medications have been used to treat inflammatory and autoimmune conditions since the 1940s. In this time, they have saved countless lives, but for many patients, they have also caused serious secondary health issues. Here’s a brief review of the key moments in the history of steroid medications, charting key developments and their impacts on patient health.
1948
The first man-made steroids are given to a 29-year-old woman with severe rheumatoid arthritis. Doctors are amazed to see that the drug reduces her inflammation so much that it restores her ability to walk in just three days.1
1948
23 days after this first use of steroids, negative effects are reported. The following day, doctors start to reduce the patient’s dose, hoping to find the ‘lowest possible therapeutic’ level (one that will treat a disease and minimize the creation of secondary health problems).
1948
The New York Times refers to cortisone as a "miracle drug" for treating arthritis, rheumatism and degenerative diseases.2
1950
The work of Philip Hench, Edward Kendall and Tadeus Reichstein on the effects of steroid hormones wins them the Nobel Prize in Medicine.3
1950
Side effects, including facial rounding, acne, hair growth, muscle weakening, increased appetite and depression, are recorded.
1951
Side effects, including hypertension (high blood pressure) and hyperglycemia (high blood sugar), are recorded.
1953
Side effects relating to an increased risk of infection are recorded.
1954
Side effects, including osteoporosis and bone fractures, are recorded.
1960
Cataracts are recorded as a side effect of steroid treatment, completing the list of common side effects we know about today.4
1972
Professor Tim Clark finds that inhaled steroids provide an effective form of asthma management, helping to limit exposure beyond the lungs and causing fewer adverse effects than steroids taken orally or injected.5
2005
Corticosteroids are voted Allergen of the Year by the American Contact Dermatitis Society. The award aims to draw attention to substances that cause significant health problems.6
2016
Concerned about the number of patients experiencing side effects, Dr John Stone, Professor of Medicine at Harvard Medical School, convenes a global team of clinicians to find an accurate way to measure steroid-toxicity. This initiative leads to the development of the Steritas Glucocorticoid Toxicity Index (GTI).7
2020
The UK’s NHS Improvement agency issues a national patient safety alert to introduce steroid emergency cards and support the early recognition and treatment of adrenal crises in adults.8
2021
Steritas is founded to help clinical researchers quantify the damage caused by steroids using the Steritas Glucocorticoid Toxicity Index (GTI).
2021
The US Food and Drug Administration (FDA) approves avacopan for the rare autoimmune condition ANCA-associated vasculitis. The approval follows the pivotal ADVOCATE trial, published in the New England Journal of Medicine,9 in which the Steritas GTI is used to measure the steroid-toxicity experienced by patients.
2021
Researchers in the UK find that the risk of cardiovascular disease increases with the dose and duration of steroid treatment, with even low daily doses increasing risk. The discovery is notable as it has previously been presumed that daily dosages under 5mg are unlikely to have these effects.
2023
Steritas launches the STOX® Suite, a collection of clinical outcome assessments for measuring steroid-toxicity. The suite is a key part of The Great TaperTM, an initiative designed to help optimize steroid use and raise awareness of the need to reduce steroids gradually via a controlled taper.
2024
Steritas launches Steroids and Me (Sam), a new digital companion to support steroid-treated patients. The companion is well received by patients, clinicians, patient advisory groups and industry partners.
Helping you ease your steroid journey
Sam was built to make it easier for patients like you to access information and expert advice about their side effects. The explore button below is a great place to start learning. If you see an article that interests you, why not use the bookmark tool to save it and refer to it later? You can also send information to your friends and family using the share icon at the top of each page.
References
1 https://www.ncbi.nlm.nih.gov/books/NBK531462/ https://www.the-rheumatologist.org/article/a-look-back-at-the-first-use-of-cortisone-in-rheumatoid-arthritis/?singlepage=1
2 https://www.nytimes.com/1949/08/17/archives/group-sent-to-hunt-cortisone-in-africa-ewing-hailing-discovery-of.html
3 History of the development of corticosteroid therapy, Clinical and experimental Rheumatology t. G. Benedek, 2011 https://www.clinexprheumatol.org/article.asp?a=5333
4 https://pubmed.ncbi.nlm.nih.gov/22018177/
5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166064/#:~:text=In%201972%2C%20Clark%20showed%20for,adverse%20effects%20than%20systemic%20steroids.
Clark TJ. Effect of beclomethasone dipropionate delivered by aerosol in patients with asthma. Lancet. 1972;1:1361–4. [PubMed] [Google Scholar]
6 "Contact Allergen of the Year: Corticosteroids: Introduction". Medscape.com. 2005-06-13. Retrieved 2012-11-30. Gumaste PV, Cohen DE, Stein JA. Bullous systemic contact dermatitis caused by an intra-articular steroid injection. Br J Dermatol. Published online ahead of print July 12, 2014.
7 https://www.sciencedirect.com/science/article/pii/S0049017222000610
8 https://www.england.nhs.uk/2020/08/steroid-emergency-card-to-support-early-recognition-and-treatment-of-adrenal-crisis-in-adults/
9 Jayne DRW, Merkel PA, Schall TJ, Bekker P; ADVOCATE Study Group. Avacopan for the Treatment of ANCA-Associated Vasculitis. N Engl J Med. 2021 Feb 18;384(7):599-609. DOI: 10.1056/NEJMoa2023386