When and for how long should glucocorticoids be used in rheumatoid arthritis? International guidelines and recommendations

Ann N Y Acad Sci. 2014 May:1318:32-40. doi: 10.1111/nyas.12452. Epub 2014 May 14.

Abstract

Glucocorticoids are widely used in rheumatoid arthritis (RA); however, their effectiveness and safety is still a subject of debate. In particular, when to introduce glucocorticoids, but also when and how to taper them, are important questions for clinicians. In this paper, we will discuss the place of glucocorticoids in the European League Against Rheumatism (EULAR) recommendations for the management of RA and review the literature that was the basis for these recommendations. The recommendations cover the introduction of glucocorticoids (and for whom they are recommended), doses and duration of treatment, and tapering strategies. Items still on the research agenda include more data on safety, particularly for long-term use, and small doses of glucocorticoids.

Keywords: EULAR; glucocorticoids; inflammation; recommendations; rheumatoid arthritis.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents / administration & dosage*
  • Antirheumatic Agents / adverse effects
  • Arthritis, Rheumatoid / drug therapy*
  • Drug Administration Schedule
  • Glucocorticoids / administration & dosage*
  • Glucocorticoids / adverse effects
  • Humans
  • Practice Guidelines as Topic

Substances

  • Antirheumatic Agents
  • Glucocorticoids