Impact of prolonged glucocorticoid therapy on physiological hemostasis and coagulation parameters

Today, GCs are applied into practice for anti-inflammatory and immunosuppressive action. Through interrupted use over time, the normal hemostatic process may consequently be disturbed. The major objective of this research was to investigate the effect of prolonged glucocorticoid therapy on the coagulation system and thrombotic and bleeding risks. Data showed that a prothrombotic condition favors long-term glucocorticoid treatment by the rise of clotting factors, the decrease of anticoagulant proteins, and disturbance of fibrinolysis process. Endothelial dysfunction and increased platelet activity also add an estimate to hypercoagulability. There are conditions under which glucocorticoids may either depress platelet function or cause thrombocytopenia, thereby increasing bleeding risks. Increasingly prolonged treatment would lead to an increase in the frequency of thromboembolic events such as deep vein thrombosis and pulmonary embolism. Risk assessment is highly individualized and may lead to consideration of preventive anticoagulation for high-risk patients, the current study points out.