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首页> 外文期刊>Rheumatology >Benefits and risks of low-dose glucocorticoid treatment in the patient with rheumatoid arthritis.
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Benefits and risks of low-dose glucocorticoid treatment in the patient with rheumatoid arthritis.

机译：类风湿关节炎患者低剂量糖皮质激素治疗的益处和风险。

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Glucocorticosteroids (GCs) have been employed extensively for the treatment of rheumatoid arthritis (RA) and other autoimmune and systemic inflammatory disorders. Their use is supported by extensive literature and their utility is reflected in their incorporation into current treatment guidelines for RA and other conditions. Nevertheless, there is still some concern regarding the long-term use of GCs because of their potential for clinically important adverse events, particularly with an extended duration of treatment and the use of high doses. This article systematically reviews the efficacy for radiological and clinical outcomes for low-dose GCs (defined as ≤10 mg/day prednisone equivalent) in the treatment of RA. Results reviewed indicated that low-dose GCs, usually administered in combination with synthetic DMARDs, most often MTX, significantly improve structural outcomes and decrease symptom severity in patients with RA. Safety data indicate that GC-associated adverse events are dose related, but still occur in patients receiving low doses of these agents. Concerns about side effects associated with GCs have prompted the development of new strategies aimed at improving safety without compromising efficacy. These include altering the structure of existing GCs and the development of delayed-release GC formulations so that drug delivery is timed to match greatest symptom severity. Optimal use of low-dose GCs has the potential to improve long-term outcomes for patients with RA.
机译：糖皮质类固醇（GCs）已广泛用于治疗类风湿关节炎（RA）和其他自身免疫和全身性炎症性疾病。它们的使用得到了广泛文献的支持，其效用体现在将其纳入有关RA和其他疾病的当前治疗指南中。然而，由于GC可能具有临床上重要的不良事件，尤其是随着治疗时间的延长和高剂量的使用，它们的长期使用仍然引起人们的关注。本文系统地回顾了低剂量GC（定义为≤10 mg /天泼尼松当量）在RA治疗中的放射学和临床结果疗效。审查的结果表明，通常与合成DMARD（通常为MTX）联合使用的低剂量GC可显着改善RA患者的结构结局并降低症状严重性。安全性数据表明，与GC相关的不良事件与剂量有关，但在接受低剂量这些药物的患者中仍会发生。对与GC相关的副作用的担忧促使人们开发了旨在提高安全性而不损害功效的新策略。这些措施包括改变现有GC的结构和开发缓释GC制剂，以便及时安排药物的投放时间以适应最大的症状严重程度。最佳使用低剂量GC可能会改善RA患者的长期预后。

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