title: "Official View" on Glucocorticoids in Rheumatoid Arthritis: A Systematic Review of International Guidelines and Consensus Statements.
abstract: To describe the perception of the current role of systemic glucocorticoids in the management of rheumatoid arthritis (RA) by examining their importance and the current level of evidence in recent guidelines, and to identify open questions to be addressed in future guidelines and research projects.
  
  
  
  We conducted a systematic literature review using the databases Ovid Embase, PubMed Medline, and Cochrane Library for guidelines on the pharmacologic treatment of RA. Retrieved articles were evaluated regarding their quality using the Appraisal of Guidelines for Research and Evaluation II tool and scrutinized for all relevant information concerning the use of glucocorticoids.
  
  
  
  All guidelines agree that glucocorticoids, especially if given at low doses and for a short duration, are an appropriate option in the treatment of RA. However, many recommendations remain vague, as reliable and detailed evidence is scarce. Important aspects of glucocorticoid therapy are partially or completely neglected, and the existing nomenclature is not used uniformly. Quality evaluation revealed flaws in many articles, concerning not only glucocorticoid-specific recommendations but also guideline quality in general.
  
  
  
  Current recommendations for use of glucocorticoids in the management of RA are suboptimal. More rigorous evaluation of doses, timing, and duration of their use is needed. Existing nomenclature on glucocorticoid therapy should be used uniformly.
authors.affiliation: Charité University Medicine, Berlin, Germany.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Palmowski
authors.affiliation: Charité University Medicine, Berlin, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Buttgereit
authors.affiliation: Medical University Graz, Graz, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Dejaco
authors.affiliation: University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Johannes W
authors.initials: JW
authors.lastname: Bijlsma
authors.affiliation: Mayo Clinic College of Medicine, Rochester, Minnesota.
authors.forename: Eric L
authors.initials: EL
authors.lastname: Matteson
authors.affiliation: University of Twente, Enschede, The Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: Voshaar
authors.affiliation: VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Boers
authors.affiliation: Charité University Medicine, Berlin, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Buttgereit
mesh_terms: D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000453:epidemiology; D002986:Clinical Trials as Topic / Q000592:standards; D032921:Consensus; D019317:Evidence-Based Medicine / Q000592:standards; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000592:standards*; D006801:Humans; D038622:Internationality; D017410:Practice Guidelines as Topic / Q000592:standards*
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids