Efficacy of Systemic Glucocorticoids in Rheumatoid Arthritis

Use of glucocorticoids (GC) began more than 50 years ago for the treatment of rheumatoid arthritis (RA). However, up until a decade ago, its potential role as a disease modifying anti-rheumatic drug (DMARD) and its capacity to prevent radiologic damage had not been proposed. Some initial studies indicated a disease modifying drug, but in the following years, probably due to questions regarding the appearance of multiple side effects, GC use started to be more cautious and few studies on their use in RA were carried out. In the past few years, different clinical trials have been published in which research into the role of low-dose GC as DMARDs in RA is carried out, as well as a characterization of side effects. They are mostly randomized clinical trials with different designs and variable followup periods; its main characteristics are summarized in Table.