title: Current use of glucocorticoids in patients with rheumatoid arthritis in Germany.
abstract: OBJECTIVE
  To describe the current use of glucocorticoids in German patients with rheumatoid arthritis (RA).
  
  
  METHODS
  We analyzed clinical and patient-derived data from 10,068 outpatients with RA from the national database of the German Collaborative Arthritis Centres for the year 2001 collected by more than 80 rheumatologists in hospitals and private practices.
  
  
  RESULTS
  Systemic glucocorticoid therapy was prescribed for 60% of all patients with RA in rheumatologic care. The proportion of patients receiving systemic glucocorticoids in addition to disease-modifying antirheumatic drug (DMARD) therapy ranged from 53% to 81% of the patients for the various DMARDs. Glucocorticoid therapy was administered more often in combination with tumor necrosis factor inhibitors (81%), cyclosporin A (80%), or leflunomide (77%) than with more traditional DMARDs such as methotrexate (63%) or sulfasalazine (55%). Regarding the prevention and treatment of osteoporosis, 63% of patients taking systemic glucocorticoids were also receiving some type of osteoporosis therapy, as opposed to only 26% of those not taking glucocorticoids.
  
  
  CONCLUSIONS
  Glucocorticoids play a pivotal role in the management of RA. This is reflected in the extensive use of low-dose glucocorticoids by German rheumatologists. Even if highly effective DMARDs are prescribed, they are accompanied by glucocorticoids, at least in the initial phase. High-dose glucocorticoids are prescribed for only a small proportion of the patients. There is increasing awareness of the risk of osteoporosis in long-term glucocorticoid treatment, demonstrated by the fact that osteoporosis medication is prescribed for a large proportion of patients taking glucocorticoids.
authors.affiliation: German Rheumatism Research Centre, Berlin.
authors.forename: Katja
authors.initials: K
authors.lastname: Thiele
authors.forename: Frank
authors.initials: F
authors.lastname: Buttgereit
authors.forename: Doerte
authors.initials: D
authors.lastname: Huscher
authors.forename: Angela
authors.initials: A
authors.lastname: Zink
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D016208:Databases, Factual; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005858:Germany; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced; D010045:Outpatients
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids