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糖皮质激素治疗类风湿关节炎的益处与风险及糖皮质激素诱导骨质疏松的管理

[Benefits and risks of glucocorticoid therapy for the treatment of rheumatoid arthritis and management of glucocorticoid-induced osteoporosis].

作者信息

Suzuki Yasuo, Wakabayashi Takayuki, Saito Eiko, Yamada Chiho, Suwa Akira

机构信息

Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine.

出版信息

Clin Calcium. 2009 Mar;19(3):404-15.

Abstract

More than 50 years have passed since glucocorticoid (GC) therapy was introduced into the treatment of rheumatoid arthritis (RA) . Although the effect of GC monotherapy on RA is limited to short-term and long-term GC treatment carries the risks of adverse effects and rebound phenomenon after the discontinuation, disease-modifying action of GC have been recently reported when used in combination with DMARDs. One of the important side effects associated with GC therapy is osteoporosis, and Japanese guidelines on the management and treatment of glucocorticoid -induced osteoporosis have been published recently. Further studies are necessary to elucidate long-term benefit-risk ratio of low-dose GC therapy on RA.

摘要

自糖皮质激素(GC)疗法被引入类风湿关节炎(RA)的治疗以来,已经过去了50多年。尽管GC单药治疗对RA的效果仅限于短期,且长期GC治疗存在不良反应风险以及停药后的反跳现象,但最近有报道称,GC与改善病情抗风湿药(DMARDs)联合使用时具有改善病情的作用。与GC治疗相关的重要副作用之一是骨质疏松症,日本关于糖皮质激素诱导骨质疏松症的管理和治疗指南最近已经发布。有必要进一步研究以阐明低剂量GC治疗RA的长期获益风险比。

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