Balancing the benefits and risks of low-dose glucocorticoid in rheumatoid arthritis.

Academic Article

Abstract

  • Glucocorticoids have potent anti-inflammatory and immunomodulatory effects and are widely use in the management of rheumatoid arthritis in combination with other synthetic and with biological disease-modifying anti-rheumatic drugs. Concerns about the risk of adverse effects of glucocorticoids, especially if they are given at higher dosages and for a longer time, hamper their use despite the clear symptomatic and disease modifying benefits. However, the evidence base for these concerns for low dose glucocorticoid therapy is quite limited due to the scarcity of quality literature on its safety in rheumatoid arthritis. This review discusses the current understanding about their disease-modifying effects, toxicity data from recent trials and observational studies, recommendations for their management and the current efforts to improve the therapeutic ratio of glucocorticoid through the development of new formulations, such as modified-release prednisone.
  • Authors

    Published In

    Keywords

  • Arthritis, Rheumatoid, Glucocorticoids, Humans, Risk Assessment
  • Author List

  • Santiago T; Jacobs JW; Saag KG; Buttgereit F; Pereira da Silva JA
  • Start Page

  • 10
  • End Page

  • 22
  • Volume

  • 40
  • Issue

  • 1