The role of low-dose glucocorticoids for rheumatoid arthritis in the biologic era

Clinical and Experimental Rheumatology

Monica Todoerti¹  Carlomaurizio Montecucco¹  Carlo Alberto Scirè¹  Roberto Caporali¹ 

关键词: Rheumatoid arthritis;    glucocorticoid;    biologics;    remission;    discontinuation;    Discontinuation of therapy;    rheumatoid arthritis;    glucocorticoids;   

DOI  :  

学科分类：医学（综合）

来源: Pacini Editore SpA

【 摘 要 】

In rheumatoid arthritis (RA), low-dose glucocorticoid (GC) therapy has a well-established effect on disease activity. Particularly in early RA, robust evidence demonstrates that GC treatment in association with standard disease-modifying anti-rheumatic drugs (DMARDs) is effective in inducing high remission rates, earlier and more persistently. Despite international recommendations that discourage long-term concomitant GC use, the majority of the clinical trials and observational registries on biologic agents include a high proportion (up to 80%) of patients in treatment with GC. From an analysis of the literature, a substantial lack of reliable information about the efficacy of GC in association with biologic agents emerges; in particular, the role of GC co-therapy in sustaining remission after biological therapy discontinuation remains to be clarified. Given the increasing prevalence of patients in sustained remission, a rational discontinuation strategy should include low-dose GCs in the experimental design to elucidate their role in inducing and maintaining biologic-free remission, for efficacy, safety and pharmacoeconomic considerations.

【 授权许可】

Unknown