“Official View” on Glucocorticoids in Rheumatoid Arthritis: A Systematic Review of International Guidelines and Consensus Statements

Abstract

Current recommendations for use of glucocorticoids in the management of RA are suboptimal. More rigorous evaluation of doses, timing, and duration of their use is needed. Existing nomenclature on glucocorticoid therapy should be used uniformly.

The 2016 Eular Guidelines for the Diagnosis and Treatment of Early Arthritis

“…Обращается особое внимание на риск НР (инфекционных осложнений и кардиоваску-лярной патологии, увеличения массы тела, артериальной гипертензии, диабета, катаракты, остеопороза), который нарастает при достижении высокой кумулятивной дозы ГК и их длительном приеме [83][84][85][86][87][88][89][90][91].…”

Glucocorticoids in Management of Adult Rheumatoid Arthritis-Current Prescribing Practices and Perceptions of Physicians in India: GLUMAR Survey

“…Moreover, there are concerns about adverse events among both physicians and patients. The risk of adverse events has potential to adversely affect the adherence and thereby the compliance [4,10]. Indian data on physician's opinions regarding use of GCs in RA are limited.…”

It is the Best of Treatments, It is the Worst of Treatments: The Continuing Love‐Hate Relationship With Glucocorticoids in Rheumatoid Arthritis

“…Their efficacy is indisputable, but unfortunately despite decades of use, many questions linger about their long‐term use and the magnitude of their risks . In this issue of Arthritis Care & Research , Palmowski et al review the “official view” of glucocorticoids in RA in their article, “‘Official View’ on Glucocorticoids in Rheumatoid Arthritis: A Systematic Review of International Guidelines and Consensus Statements” . The authors have raised a number of important issues in regards to the use of these drugs, such as effects of age, weight, and timing, which cannot be fully addressed due to lack of data.…”

“…Palmowski et al suggest that there are not enough data on the use of glucocorticoids in RA . With regard to dosing and toxicity, this is true.…”

“…This makes it more difficult to tease out their unique risk profiles. Palmowski et al raise additional valid concerns about the effects of age and weight on dosing and about the lack of uniformity in terminology. Unfortunately, with funding issues, it is uncertain whether good data will be obtained any time soon.…”