title: [Long-term glucocorticoid therapy : Is there a safe dosage?].
abstract: Glucocorticoids have been successfully used for a long time to treat a wide range of chronic inflammatory diseases. Despite the well-accepted efficacy, possible adverse effects still provoke discussions among patients and physicians. In particular, the long-term use of glucocorticoids at higher dosages may cause unwanted adverse effects; therefore, the question arises if conditions for a safe long-term treatment regimen with these drugs can be defined. Studies specifically and comprehensively addressing this question are missing; therefore, a multidisciplinary task force comprised of medical experts and patients was formed to analyze and discuss the existing literature in order to identify conditions where long-term glucocorticoid treatment has an acceptably low level of harm. The group agreed that the actual level of harm of long-term glucocorticoid therapy depends on both drug (dose and duration) and patient-specific characteristics. The patient-specific parameters (some of which can be modified by patients and/or physicians) should always be monitored before and during treatment with glucocorticoids and optimized if necessary. A positive benefit-risk ratio can be achieved when current knowledge and existing recommendations are kept in mind and implemented in clinical practice.
authors.affiliation: Medizinische Klinik mit Schwerpunkt Rheumatologie und klinische Immunologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. cindy.strehl@charite.de.|Deutsches Rheuma-Forschungszentrum (DRFZ), Berlin, Deutschland. cindy.strehl@charite.de.
authors.forename: C
authors.initials: C
authors.lastname: Strehl
authors.affiliation: Medizinische Klinik mit Schwerpunkt Rheumatologie und klinische Immunologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.|Deutsches Rheuma-Forschungszentrum (DRFZ), Berlin, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Buttgereit
mesh_terms: D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology* / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D000069451:Long Term Adverse Effects / Q000139:chemically induced* / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids
keywords: Adverse events; Benefit-risk ratio; Patient specific factors; Rheumatoid arthritis; Risk factors