title: Glucocorticoids in the treatment of rheumatoid arthritis.
abstract: Glucocorticoids (GC) are now being used for over 65 years in the treatment of rheumatoid arthritis (RA). There is by now good evidence for their disease modifying effect, especially in early RA. When used in a dosage of 7.5-10 mg most adverse effects can be quite well handled, though monitoring and awareness for infections are important. The CAMERA II study is discussed, in which patients with early RA were treated with a tight control scheme of climbing dosages of methotrexate plus either 10 mg prednisone daily or placebo. After the two years of the trial, 70% of the patients treated with tight control strategy without GC had no erosions versus 82% of the patients treated with additional prednisone. Remission was reached more often and earlier on in the strategy with prednisone compared to the strategy with placebo. It may be suggested that GC have a greater beneficial effect on joint structure than can be explained by their anti-inflammatory effects only.
authors.affiliation: Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, The Netherlands. j.w.j.bijlsma@umcutrecht.nl.
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
authors.affiliation: Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, The Netherlands.
authors.forename: Johannes W G
authors.initials: JW
authors.lastname: Jacobs
authors.affiliation: Department of Rheumatology and Clinical Immunology, Charité Universitätsmedizin Berlin, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Buttgereit
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D012074:Remission Induction; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids