Glucocorticoids: action and new therapeutic insights in rheumatoid arthritis.
OBJECTIVE
To summarize the mechanism of action of glucocorticoids, the direction that current research is taking and what this might mean for clinicians.


RESULTS
New cellular actions of glucocorticoids have been identified, and offer new drug targets. There is increasing competition to find a glucocorticoid formulation or analogue that enhances therapeutic effects while reducing adverse effects. Clinically, there is increasing evidence for the disease-modifying effects of glucocorticoids, which makes these developments topical and relevant. Better understanding of the pathology of rheumatoid arthritis and the circadian variation in symptoms that is a hallmark of the disease may also affect the way that we use these drugs.


CONCLUSIONS
Glucocorticoids are about to enter a renaissance based on better understanding of how they work and novel approaches to new therapeutic targets.
Kirwan
John
J
University of Bristol Academic Rheumatology Unit, Bristol Royal Infirmary, Bristol, UK. John.Kirwan@bristol.ac.uk
Power
Lynsey
L
D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000378:metabolism; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008954:Models, Biological; D011965:Receptors, Glucocorticoid / Q000187:drug effects
D018501:Antirheumatic Agents; D005938:Glucocorticoids; D011965:Receptors, Glucocorticoid