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Use of glucocorticoids in the treatment of rheumatoid arthritis

James R O'Dell, MD
Eric L Matteson, MD, MPH
Section Editor
Ravinder N Maini, BA, MB BChir, FRCP, FMedSci, FRS
Deputy Editor
Paul L Romain, MD


In the early 1950s, Hench and colleagues earned a Nobel Prize in medicine and physiology for discovering the dramatic beneficial effect of cortisone on a patient incapacitated by rheumatoid arthritis (RA). Since that time, the exact role of glucocorticoids in the treatment of RA has generated considerable debate.

Glucocorticoids exert both antiinflammatory and immunosuppressive effects via several mechanisms [1] (see "Glucocorticoid effects on the immune system"). Among those pertinent to patients with RA are the following:

Inhibition of prostaglandin and leukotriene synthesis

Reductions in macrophage phagocytosis, in interleukin (IL)-1 secretion, and in the number of circulating monocytes

Inhibition of the release of collagenase and lysosomal enzymes

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Literature review current through: Nov 2017. | This topic last updated: Jun 26, 2017.
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