Glucocorticoids in systemic lupus erythematosus: future of steroid-sparing therapy

The isolation of glucocorticoids (GC) was a tremendous achievement in the history medicine and had clinical impact similar to that discovery insulin or antibiotics. However, with expansion their use, multiple side effects have become evident even patients treated low doses. GC remain one main agents treatment systemic lupus erythematosus (SLE). studies genomic nongenomic justified use lower starting doses (e.g. 30 40 mg daily) patiens nephritis. Methylprednisolone pulses early initiation hydroxychloroquine immunosuppressive may allow more rapid tapering discontinuation SLE patients. Development novel steroid-sparing agents, e.g. anifrolumab, monoclonal antibody interferon I receptor, voclosporin, an oral calcineurin inhibitor, result further improvement efficacy safety treatment.