Low-dose corticosteroids and disease modifying drugs in patients with rheumatoid arthritis

Low-dose glucocorticoids (GCs) exhibit a differential effect on continuation of disease-modifying anti-rheumatic drugs (DMARDs), and the degree of adverse effects (AE) associated with DMARDs. Therefore, GCs address important problems in DMARD use in rheumatoid arthritis (RA), i.e. cumulative toxicity and frequent AE. Low-dose GCs often are recommended to achieve a better symptomatic control or as 'bridge therapy' before the onset of action of DMARDs. RA patients with GC co-medication had better radiographic outcomes but experienced more GC-related AE. Further long-term studies are needed to focus on timing of administration, duration and identification of risk factors for developing AE to establish the optimal use of GCs in the treatment of RA.