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Rheumatoid arthritis

Glucocorticoids in the treatment of early and late RA

J W J Bijlsma¹, M Boers², K G Saag³, D E Furst⁴

¹ Department of Rheumatology and Clinical Immunology (F02.127), University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
² Department of Clinical Epidemiology and Biostatistics, VU Medical Centre, Amsterdam, The Netherlands
³ Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
⁴ Department of Rheumatology, University of California, Los Angeles, CA, USA

Correspondence to:
Correspondence to:
Professor J W J Bijlsma;
j.w.j.bijlsma@azu.nl

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A little GC, like a glass of wine, may benefit many people, whereas a high dose of GC, like a bottle of wine, is harmful to all

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Keywords: Glucocorticoids; rheumatoid arthritis; adverse effects; disease modifying

The first 150 words of the full text of this article appear below.

At the 2003 meeting of the American College of Rheumatology (ACR) a debate on the advantages and disadvantages of glucocorticoids (GCs) in the treatment of early and late rheumatoid arthritis (RA) was held, with some authors putting the case for, and others the case against, such treatment (presentations now available online: http://www.rheumatology.org). Some new data emerged, and this paper summarises the arguments and the existing and new data.

Hench was awarded the Nobel prize in 1950 for the discovery of GCs and their effect in established RA. However, subsequently disillusionment with GCs set in, caused by the rapid appearance of unacceptable side effects of long term high dose treatment, and loss of efficacy at lower dosing. The dogma became that treatment with systemic GCs caused only temporary symptomatic relief, led to habituation with danger of ever increasing doses necessary to maintain effect, and that chronic treatment universally . . . [Full text of this article]

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Glucocorticoids in Rh A.

Tony S Russell

Ann Rheum Dis Online, 18 Dec 2003 [Full text]