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Appropriate and inappropriate use of oral glucocorticoid therapy in rheumatoid arthritis.

机译:在类风湿关节炎中适当和不适当地使用口服糖皮质激素治疗。

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摘要

Oral glucocorticoid therapy has been used to treat rheumatoid arthritis (RA) for decades. The considerable enthusiasm generated initially by the therapeutic effects of glucocorticoids was rapidly dampened by reports of multiple adverse effects. Although glucocorticoid therapy remains a major weapon against RA, it is only used after a careful evaluation of the risk/benefit ratio, which varies according to the patient, the clinical situation, and the therapeutic alternatives available at the time. Thus, no single definition can be given for "appro-priate" and "inappropriate" use of glucocorticoid therapy. Furthermore, the title of this editorial may suggest the existence of scientifically determined rules for prescribing glucocorticoid therapy, with any deviation from those rules putting the patient at risk. However, although scientific studies have provided useful information, many issues remain unresolved, and as a result physicians must make their own decisions based on their sensitivity, experience, and personal beliefs.
机译:口服糖皮质激素疗法已用于治疗类风湿关节炎(RA)数十年。最初由糖皮质激素的治疗​​作用产生的极大热情被多种不良反应的报道迅速削弱。尽管糖皮质激素疗法仍然是抵抗RA的主要武器,但只有在仔细评估风险/获益比后才使用糖皮质激素,但风险/获益比会根据患者,临床情况以及当时可用的治疗方法而有所不同。因此,对于糖皮质激素治疗的“适当”和“不适当”使用,不能给出单一定义。此外,该社论的标题可能暗示存在科学确定的糖皮质激素治疗处方规则,而与这些规则的任何偏离均会使患者处于危险之中。但是,尽管科学研究提供了有用的信息,但许多问题仍未解决,因此,医师必须根据自己的敏感性,经验和个人信念做出自己的决定。

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