Long-term glucocorticoid treatment may shape how children with rheumatic diseases experience their daily lives, but the evidence remains thin and inconsistent, according to a scoping review published in BMC Rheumatology on 25 September 2026.
Glucocorticoids such as prednisone, prednisolone and intravenous methylprednisolone are commonly prescribed for moderate and severe rheumatic diseases in children, including juvenile idiopathic arthritis, childhood-onset systemic lupus erythematosus and juvenile dermatomyositis. While effective, long-term use is associated with frequent adverse effects such as osteoporosis, obesity and poor psychosocial health, making health-related quality of life an important outcome to study.
Researchers led by Renee X. Pang and colleagues conducted the scoping review using a PRISMA-ScR protocol. They searched MEDLINE, EMBASE, APA, CINAHL, Web of Science and the Cochrane Central Register of Controlled Trials from inception to May 2022, then updated the search from May 2022 to August 2025, screening newly identified records in Covidence under the same eligibility criteria.
From 541 retrieved records, only seven studies met the inclusion criteria. Six were cross-sectional analytical studies and one was a prospective cohort study. The small number and largely cross-sectional design of the available research underscore how little is directly known about this question.
Three of the seven studies reported lower health-related quality of life for children with rheumatic diseases on long-term glucocorticoids, with impacts related to physical appearance changes and obesity. Two studies described deficits in emotional functioning, such as anxiety. Patients reported that glucocorticoid-related adverse effects were important factors to consider in their treatment.
The review also found that longer courses and higher doses of glucocorticoid treatment were associated with a greater frequency of side effects and more disease-related damage, especially when treatment extended beyond five years. These associations come from observational data, so they describe patterns rather than proven causal effects.
Overall, the authors concluded that glucocorticoid treatment was associated with specific emotional quality-of-life outcomes in some studies, but showed no consistent association with overall changes in health-related quality of life, with at least one study reporting improvement. Whether any observed differences reflect the medication itself or the underlying disease activity remains unclear, a limitation the authors emphasize.
The review used the Quality In Prognosis Studies (QUIPS) tool for critical appraisal of the included studies. As a scoping review, it maps the existing evidence rather than pooling effect estimates, and its findings are constrained by the small, heterogeneous body of primary research available.
The authors call for standardized health-related quality of life measures in future research to clarify how much of the burden children experience stems from glucocorticoid therapy and how much from the diseases being treated. Until such studies are done, the picture painted by the seven available studies is suggestive but far from definitive.
Subject of Research: The impact of long-term glucocorticoid treatment on health-related quality of life in children with rheumatic diseases
Article Title: The impact of glucocorticoid treatment on health-related quality of life in children with rheumatic diseases: a scoping review
Article References: Pang, R. X., Murray, B., Litman, K., Zebian, A., Park, J., Rieder, M. J., & Berard, R. (2026). The impact of glucocorticoid treatment on health-related quality of life in children with rheumatic diseases: a scoping review. BMC Rheumatology. https://doi.org/10.1186/s41927-026-00691-3
Image Credits: AI Generated
DOI: 10.1186/s41927-026-00691-3
Keywords: glucocorticoids, children, rheumatic diseases, juvenile idiopathic arthritis, systemic lupus erythematosus, juvenile dermatomyositis, quality of life, scoping review, adverse effects, prednisone, BMC Rheumatology, impact
News Source: Ophelia Keating. (October 29, 2026). Glucocorticoids in childhood rheumatic disease: scoping review probes quality-of-life toll. Scienmag.
