Effects of glucocorticoids on inflammation and arthritis

Introduction Glucocorticoids were introduced to the world via their successful use in the treatment of rheumatoid arthritis (RA) over 50 years ago. Despite major advances in the use of disease-modifying antirheumatic drugs (DMARDs) and the development of biological targeted therapies for RA and related conditions, glucocorticoids remain used chronically in approximately one-half of all patients with RA. Considerable, predictable, dose-dependent toxicity accompanies the use of glucocorticoids. Researchers have for many years therefore striven to learn more about the actions of glucocorticoids in order to develop therapies that deliver the anti-inflammatory and immunosuppressive benefits without the accompanying toxicity. In recent years, including the year under review, significant developments in the basic science of glucocorticoids have greatly aided the achievement of this goal, which, nonetheless, remains out of reach at present. With the same goal of reduced toxicity in mind, however, researchers have studied the use of very low doses of glucocorticoids in diseases such as RA, with clear indications of benefit evident in studies published in the past year.