@article{b63b1a343abe4f81b1beebc719ed2f2d,
title = "The safety of glucocorticoids in the treatment of inflammatory rheumatic disease: new evidence",
abstract = "Purpose of review Glucocorticoids justifiably remain a cornerstone in the treatment of many inflammatory rheumatic diseases but many are opposed to their use because of the side effects, most of them known to be dose-dependent. Most concerns regarding glucocorticoids stem from observational studies which are affected by several forms of bias, mainly confounding by indication, that may result in overestimation of harm. Solid evidence regarding the safety of low-dose glucocorticoids remains remarkably scarce. Recent findings Several observational studies showed heterogeneous results and two 6-month trials showed no increase of harm. The GLORIA trial of 5mg/day prednisolone vs. placebo in patients aged 65{\th} is the first randomized control trial with glucocorticoids safety as coprimary outcome. The benefits of glucocorticoids in terms of symptoms and structural damage were confirmed, but the proportion of patients with at least one adverse event of special interest (serious or glucocorticoids-related) was increased by 24%, mostly due to nonsevere infections. Summary Based on current evidence the benefit-risk balance of low-dose glucocorticoids in rheumatoid arthritis, and probably in other rheumatic diseases is generally favourable. Physicians should be aware of the risks and mitigate them, but avoid the negative effects of unfounded fear.",
keywords = "glucocorticoids, risk, safety, toxicity",
author = "Mariana Lu{\'i}s and Maarten Boers and Ken Saag and Frank Buttgereit and {da Silva}, {Jos{\'e} A. P.}",
note = "Funding Information: M.L. and J.A.P.d.S. report no conflicts of interest. M.B. reported receiving consultancy fees, honoraria and travel expenses from Novartis. K.S. reported receiving grant support from Amgen, Radius and Mereo. F.B. reported receiving consultancy fees, honoraria and travel expenses from Abbvie, AstraZeneca, Gr{\"u}nenthal, Horizon Therapeutics, Pfizer and Roche, and grant support from Abbvie, Horizon Therapeutics, Pfizer and Roche. F.B. is the PI of the Rh-GIOP study which was or is supported by a joint funding of Amgen, Biogen, BMS, Chugai, Generic Assays, GSK, Hexal, Horizon Therapeutics, Lilly, Medac, Mundipharma, Novartis, Pfizer, Roche and Sanofi. Funding Information: M.L. and J.A.P.d.S. report no conflicts of interest. M.B. reported receiving consultancy fees, honoraria and travel expenses from Novartis. K.S. reported receiving grant support from Amgen, Radius and Mereo. F.B. reported receiving consultancy fees, honoraria and travel expenses from Abbvie, AstraZeneca, Gr{\"u}nenthal, Horizon Therapeutics, Pfizer and Roche, and grant support from Abbvie, Horizon Therapeutics, Pfizer and Roche. F.B. is the PI of the Rh-GIOP study which was or is supported by a joint funding of Amgen, Biogen, BMS, Chugai, Generic Assays, GSK, Hexal, Horizon Therapeutics, Lilly, Medac, Mundipharma, Novartis, Pfizer, Roche and Sanofi. Publisher Copyright: Copyright {\textcopyright} 2022 Wolters Kluwer Health, Inc. All rights reserved.",
year = "2022",
month = may,
day = "1",
doi = "https://doi.org/10.1097/BOR.0000000000000870",
language = "English",
volume = "34",
pages = "179--186",
journal = "Current Opinion in Rheumatology",
issn = "1040-8711",
publisher = "Lippincott Williams and Wilkins",
number = "3",
}