Reference : Balancing benefits and risks of glucocorticoids in rheumatic diseases and other infla...
Scientific journals : Article
Human health sciences : General & internal medicine
http://hdl.handle.net/2268/198310
Balancing benefits and risks of glucocorticoids in rheumatic diseases and other inflammatory joint disorders: new insights from emerging data. An expert consensus paper from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO)
English
Cooper, C. []
Bardin, T. []
Brandi, M.L. []
Cacoub, P. []
Caminis, J. []
Civitelli, R. []
Cutolo, M. []
Dere, W. []
Devogelaer, J.P. []
Diez-Perez, A. []
Einhorn, T.A. []
Emonts, P. []
Ethgen, Olivier mailto [Université de Liège > Département des sciences de la santé publique > Santé publique : aspects spécifiques >]
Kanis, J.A. []
Kaufman, J.M. []
Kvien, T.K. []
Lems, W.F. []
McCloskey, E. []
Miossec, P. []
Reiter, S. []
Ringe, J. []
Rizzoli, R. []
Saag, K. []
Reginster, Jean-Yves mailto [Université de Liège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé >]
Feb-2016
Aging Clinical and Experimental Research
Springer
28
1
1-16
Yes (verified by ORBi)
International
1594-0667
1720-8319
Italy
[en] Rheumatoid arthritis ; Rheumatic diseas ; Osteoporosis ; Cohort studies ; Glucocorticoids ; Inflammation
[en] Purpose: This consensus review article considers the question of whether glucocorticoid (GC) therapy is still relevant in the treatment of rheumatic diseases, with a particular focus on rheumatoid arthritis (RA), and whether its side effects can be adequately managed. Recent basic
and clinical research on the molecular, cellular and clinical effects of GCs have considerably advanced our knowledge in this field. An overview of the subject seems appropriate.
Methods: This review is the result of a multidisciplinary expert working group, organised by European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis. The recent literature was surveyed and the salient evidence synthetized.
Results: The pathophysiological basis of RA (and other inflammatory rheumatic diseases) now strongly implicates the adaptive immune system in addition to innate mechanisms.
The molecular effect of GCs and differential GC sensitivity is better understood, although exploiting this knowledge is still in its infancy. The newer treatment strategies of early and aggressive control of RA have greatly improved clinical outcomes, but improvements are
still possible. Newer targeted anti-inflammatory drugs have made an important impact, yet they too are associated with numerous side effects.
Discussion: Short durations of moderate doses of GCs are generally well tolerated and have a positive benefit/risk ratio. Patients should be assessed for fracture risk and bone preserving agents and be prescribed calcium and vitamin D supplementation.
Conclusions: Within a strategy of a disease modifying approach to inflammatory disease, combination therapy including a GC is effective approach.
http://hdl.handle.net/2268/198310
10.1007/s40520-015-0522-1

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