Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, the Netherlands.
Clin Exp Rheumatol. 2011 Sep-Oct;29(5 Suppl 68):S116-20. Epub 2011 Oct 22.
Glucocorticoids (GCs) play an important role in the treatment of rheumatic diseases, but adverse events (AEs) are common, particularly at high doses. By identifying perspectives of patients and rheumatologists on GC therapy reasons for concerns about GC therapy and resistance to this treatment were evaluated. Both patients and rheumatologists expressed concerns about AEs like osteoporosis, diabetes and cardiovascular diseases. These concerns and the fact that many GC-related AEs are - at least in part - preventable or treatable, underline the importance of identification of AEs. The EULAR Task Force on Glucocorticoids developed recommendations for monitoring of AEs during low-dose GC therapy in daily practice and clinical trials, which were based on literature, perspectives of patients and rheumatologists and issues such as clinical relevance. Safe treatment with low-dose GCs in daily practice can be enhanced with use of a limited set of recommendations. In clinical trials, monitoring of a more comprehensive set of AEs is recommended, because this will also contribute to the identification of the relevant AE-profile of GC therapy.
糖皮质激素（GCs）在治疗风湿性疾病中发挥着重要作用，但不良反应（AEs）很常见，尤其是在高剂量时。本研究通过确定患者和风湿病医生对 GC 治疗的看法，评估了他们对 GC 治疗的担忧和对这种治疗的抵抗的原因。患者和风湿病医生都对骨质疏松症、糖尿病和心血管疾病等不良反应表示担忧。这些担忧以及许多 GC 相关不良反应至少部分是可以预防或治疗的，这突显了识别不良反应的重要性。EULAR 糖皮质激素工作组根据文献、患者和风湿病医生的观点以及临床相关性等问题，为低剂量 GC 治疗中不良反应的监测制定了在日常实践和临床试验中的建议。在日常实践中，使用有限的建议集可以增强低剂量 GCs 的安全治疗。在临床试验中，建议监测更全面的一组不良反应，因为这也有助于确定 GC 治疗的相关不良反应概况。
