University of Bristol, United Kingdom.
Clin Exp Rheumatol. 2011 Sep-Oct;29(5 Suppl 68):S52-8. Epub 2011 Oct 21.
The discovery and subsequent therapeutic use of glucocorticoids, which took 30 years, was stimulated by clinical observation and achieved by persistent investigation. Early reports of the potential of glucocorticoids to modify the underlying course of rheumatoid arthritis (RA) were overshadowed by pharmaceutical innovations with symptom relieving non-steroidal anti-inflammatory drugs (NSAIDs), and it was not until 1995 that clear-cut evidence of a powerful glucocorticoid disease-modifying action was published as the Arthritis Research Campaign Low-dose Glucocorticoid Study. This review reports how the study came to be designed and implemented, adds some additional information from the study not previously published, and considers the subsequent impact of the 1995 paper. Eighty years after Hench and colleagues made their first suggestion of benefit the UK National Health Service suggested all patients newly diagnosed with RA should have early access to glucocorticoid treatment.
糖皮质激素的发现和随后的治疗应用历时 30 年，这是受到临床观察的刺激，并通过持续的研究得以实现的。糖皮质激素有潜力改变类风湿关节炎（RA）根本病程的早期报告，被具有缓解症状的非甾体抗炎药（NSAIDs）的药物创新所掩盖，直到 1995 年，才发表了强有力的糖皮质激素疾病修饰作用的明确证据，即关节炎研究协会低剂量糖皮质激素研究。这篇综述报告了该研究是如何设计和实施的，增加了一些之前未发表的研究中的附加信息，并考虑了 1995 年论文的后续影响。亨奇及其同事首次提出获益建议 80 年后，英国国民保健制度建议所有新诊断为 RA 的患者应尽早使用糖皮质激素治疗。
