Department of Rheumatology and Clinical Immunology, Charité University Hospital, Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany.
Curr Opin Pharmacol. 2010 Jun;10(3):302-7. doi: 10.1016/j.coph.2010.02.001. Epub 2010 Mar 2.
Glucocorticoids (GCs) provide one of the most effective treatments for rheumatoid arthritis (RA); however, their long-term use is marred by undesired side effects. Increased understanding of the mechanisms of glucocorticoid action enables the development of novel drugs, such as SEGRAs or liposomal glucococorticoids, trying to improve their benefit/risk ratio. But also trying to optimise the use of conventional glucocorticoids is a sensible approach. One example is a new modified release prednisone tablet formulation that has been recently shown to be clinically and significantly better than the conventional immediate-release preparation with respect to reducing morning stiffness of the joints. The 'old spear' can also be sharpened by collecting clear-cut evidence on the efficacy and safety of conventional glucocorticoid therapy and deriving from that reliable evidence-based recommendations. This short review summarises the current knowledge in this regard, with particular emphasis on recently published articles.
糖皮质激素（GCs）为治疗类风湿关节炎（RA）最有效的方法之一；然而，其长期应用存在一些不理想的副作用。对糖皮质激素作用机制的深入了解使得新型药物得以发展，如 SEGRAs 或脂质体糖皮质激素，试图改善其获益/风险比。但尝试优化常规糖皮质激素的使用也是合理的方法。例如，最近有研究表明，一种新型的改良释放泼尼松片剂制剂在减少关节晨僵方面的临床效果明显优于传统的即刻释放制剂。通过收集关于常规糖皮质激素治疗的疗效和安全性的明确证据，并从中得出可靠的基于证据的建议，也可以“磨利旧矛”。这篇简短的综述总结了这方面的最新知识，特别强调了最近发表的文章。
