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Long-term corticosteroid harm — DGM MCQ

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HardPolypharmacyLong-term corticosteroid harmDGM

An 80-year-old woman with osteoporosis and recurrent falls has been taking prednisolone 10 mg daily for presumed polymyalgia rheumatica for 18 months. She also takes alendronate, lansoprazole, ramipril and paracetamol. ESR is normal and she has proximal weakness rather than pain. Which medication should be reviewed?

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Correct answer: C — Prednisolone

Long-term systemic corticosteroids increase osteoporosis, myopathy, diabetes and infection risk and should be reviewed when the indication is uncertain. Alendronate is protective rather than harmful in this context. Steroid myopathy can mimic frailty and worsen falls.

Reference: BNF; STOPP/START criteria v3