Glucocorticoids in rheumatoid arthritis: lessons from the Utrecht study.
The lessons from the Utrecht study on glucocorticoid therapy in early rheumatoid arthritis and of the spin-off and follow-up studies are reviewed. The data indicate that: glucocorticoids are DMARDs, the joint-sparing effect is predominantly on erosions, glucocorticoids do not influence the percentage of patients developing erosive disease, and the gain in joint-sparing effect persists after the stop of treatment. Further lessons are that the size of the joint-sparing effect and the (presumed) size of the symptomatic effect of glucocorticoids depend on co-therapies. Additional DMARDs must be added to glucocorticoids for maximum effect on radiographic progression. Finally, low-dose glucocorticoids are safer than often thought.
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands. j.w.g.jacobs@azu.nl
J W G
JW
Jacobs
J W J
JW
Bijlsma
D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D016032:Randomized Controlled Trials as Topic
D018501:Antirheumatic Agents; D005938:Glucocorticoids