Glucocorticoids in rheumatology: myths vs. reality

Abstract

Glucocorticoids (GC) have been the mainstay of practicing rheumatologists since the Nobel Prize was awarded for the discovery of cortisone in 1950. It has been proven that GC have highly effective anti-inflammatory and immunosuppressive properties. Identification of genomic and non-genomic effects, which directly affect most pathogenetic processes in the course of rheumatic diseases, served as the basis for the implementation of GC in routine rheumatological therapy. The further widespread introduction of GC into rheumatology practice is due to low cost, high availability, quick onset of action, and activity aimed at preventing organ damage. The optimal choice for the use of GC in the treatment of rheumatic diseases is a specific and individual approach in dosage and routine monitoring. To date, there are no reliable tools for determining the toxicity of GC, which is associated with poor compliance, acute onset or chronic course of adverse events AE, variability in the duration of GC use, and the need for the different dosages to control diseases.