Glucocorticoids in rheumatoid arthritis: effects on erosions and bone.
Recently, four prospective placebo-controlled studies have further evaluated the disease-modifying properties of glucocorticoids in the treatment of rheumatoid arthritis. These studies irrefutably show that the use of (low) doses of glucocorticoids leads to a significant retardation of the progression of erosions, especially in early rheumatoid arthritis. This effect on erosions seems more impressive and probably more persistent than the well-known relief during low-dose glucocorticoid therapy of symptoms, such as pain, stiffness, and joint scores. The management of the (side) effects of glucocorticoids on bone has clearly improved in the last years. These two developments lead to a further optimizing of glucocorticoid treatment in patients with rheumatoid arthritis.
Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, the Netherlands. j.w.j.bijlsma@azu.nl
Johannes W J
JW
Bijlsma
Amalia A
AA
Van Everdingen
Margriet
M
Huisman
Ron N J T L
RN
De Nijs
Johannes W G
JW
Jacobs
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D001862:Bone Resorption / Q000139:chemically induced; D001842:Bone and Bones / Q000187:drug effects* / Q000473:pathology; D002358:Cartilage, Articular / Q000187:drug effects* / Q000473:pathology; D018849:Controlled Clinical Trials as Topic; D004311:Double-Blind Method; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D010006:Osteoblasts / Q000187:drug effects; D010010:Osteoclasts / Q000187:drug effects; D010012:Osteogenesis / Q000187:drug effects; D010024:Osteoporosis / Q000139:chemically induced / Q000517:prevention & control; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013256:Steroids; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D013256:Steroids