Can we use steroid hormones to immunomodulate rheumatic diseases? Rheumatoid arthritis as an example.
This review discusses the available clinical trials in which steroids have been used in the (adjuvant) treatment of rheumatoid arthritis. Glucocorticosteroids have a positive effect on symptoms and signs of inflammation, but probably not on structural damage. Therefore glucocorticosteroids should be used as part of a long-term treatment strategy, including disease modifying drugs. Preventive measures regarding osteoporosis and peptic ulcer disease are now possible, and an active screening for potential adverse effects is advisable. The benefit of adjuvant treatment with sex hormones is limited. Estrogens have a slight positive effect in postmenopausal women on disease activity and bone mass. Androgens have a slight positive effect in men and postmenopausal women, especially on general well-being and bone mass.
Department of Rheumatology & Clinical Immunology, University Medical Centre Utrecht, The Netherlands.
J W
JW
Bijlsma
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000728:Androgens / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D004967:Estrogens / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006728:Hormones / Q000627:therapeutic use*; D006801:Humans; D012216:Rheumatic Diseases / Q000188:drug therapy*
D000276:Adjuvants, Immunologic; D000728:Androgens; D004967:Estrogens; D005938:Glucocorticoids; D006728:Hormones