Implications of corticosteroid use in multimorbidity: a detailed analysis of large-scale data
Supervisors:
Prof Sara Brown, Centre for Inflammation Research (University of Edinburgh)
Dr Daniel Morales, Division of Population Health and Genomics (University of Dundee)
Dr Clare MacRae, Usher Institute (University of Edinburgh)
Summary:
Corticosteroids are commonly prescribed medicines to reduce inflammation for a broad range of diseases. However, corticosteroids can cause side effects impacting multiple organs and systems. Conversely, people with multimorbidity may be treated with a variety of corticosteroid preparations. Many of the adverse effects remain unquantified despite the potential for long-term disability. Corticosteroids are inexpensive drugs, and more accessible than many corticosteroid-sparing agents. Inequalities in access to care and funding recommendations may mean corticosteroids are prescribed to some people more than others.
This project will apply epidemiological methods to large observational datasets to characterise diseases requiring corticosteroids and to quantify morbidity and mortality risks from corticosteroid use.
The successful candidate will train in methodological approaches including:
1. Systematic review of pharmacodynamic clinical trial data to understand systemic bioequivalence between corticosteroid drug substances and their routes of administration.
2. Analysis of linked routinely collected primary care electronic health record data to perform population-level drug utilisation studies examining prescribing patterns, compared to guideline recommendations.
3. Epidemiological methods focused on causal inference, cumulative exposure modelling and target trial emulation to quantify corticosteroid-related side effects and potential interactions with other medications.
This work will better inform clinical, regulatory and guideline decision making for the future.