Systemic corticosteroids in rheumatoid arthritis: to use or not to use?

• Published in: Nihon rinshō Vol. 60; no. 12; p. 2364
• Main Author: Amano, Koichi
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.12.2002
• Subjects: Adrenal Cortex Hormones - adverse effects; Adrenal Cortex Hormones - therapeutic use; Antirheumatic Agents - adverse effects; Antirheumatic Agents - therapeutic use; Arthritis, Rheumatoid - drug therapy; Humans; Quality of Life
• ISSN: 0047-1852

Systemic corticosteroids(steroids) were initially introduced after the dramatic efficacy in individual patients with rheumatoid arthritis(RA). Since the outcome of steroid therapy in RA turned to be awesome, steroids had been put at the apex of the therapeutic pyramid for a long time. However, most rheumatologists have subscribed steroids for the treatment of early active RA because they can provide rapid and significant clinical response. Moreover, recent several studies have shown that low dose(5 to 10 mg/day) of prednisolone retard joint destruction in a few years. However, the demonstrated negatives(opportunistic infections, osteoporosis, metabolic disorders, atherosclerotic vascular events etc.) of steroids may outweigh these advantages in the longterm clinical course of RA.