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Glucocorticoids in rheumatoid arthritis: current status and future studies
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Glucocorticoids in rheumatoid arthritis: current status and future studies
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Journal Article
Glucocorticoids in rheumatoid arthritis: current status and future studies
2020
Overview
Since their first use for treating rheumatoid arthritis (RA) in the late 1940s, glucocorticoids (GCs) have been representing a substantial part of the therapeutic arsenal for RA. However, even if GCs are still widely prescribed drugs, their toxicity is discussed controversially, so obtaining consensus on their use in RA is difficult. Hence, the most recent European League Against Rheumatism and American College of Rheumatology recommendations on early arthritis and RA management advocate the use of GCs as adjunct treatment to conventional synthetic disease-modifying antirheumatic drugs, at the lowest dose possible and for the shortest time possible. However, the recommendations remain relatively vague on dose regimens and routes of administration. Here, we describe literature data on which the current recommendations are based as well as data from recent trials published since the drafting of the guidelines. Moreover, we make proposals for daily practice and provide suggestions for studies that could help clarifying the place of GCs in RA management. Indeed, numerous items, including the benefit/risk ratio of low-dose and very low-dose GCs and optimal duration of GCs as bridging therapy, remain on the research agenda, and future studies are needed to guide the next recommendations for RA.
Publisher
EULAR,BMJ Publishing Group LTD,BMJ,BMJ Publishing Group
Subject
/ Antirheumatic Agents - administration & dosage
/ Antirheumatic Agents - therapeutic use
/ Arthritis, Rheumatoid - drug therapy
/ Drug Administration Schedule
/ Evidence-Based Medicine - methods
/ Glucocorticoids - administration & dosage
/ Glucocorticoids - therapeutic use
/ Humans
/ Practice Guidelines as Topic
/ Randomized Controlled Trials as Topic
/ Rhumatology and musculoskeletal system
/ Studies
