[Pharmacology of glucocorticoids]

Although Nobel Prize was attributed to three searchers more than 60 years ago for their discovery of corticosteroids, this therapeutic class remains one of the most prescribed nowadays. The mechanism of action of corticosteroids has not been known since very long and active fundamental research is still very intensive in order to design new drugs able to have all the inhibitory properties without the agonist properties at the level of gene transcription. These new concepts would allow better tolerability. After recording structure-activity properties of steroids, all the pharmacological aspects are reviewed in order to better understand the mechanisms of adverse drug side effects and try to understand them best. All the improvements concerning local topics, especially in the field of dermatology and asthma, have already been a major step towards better tolerance. The most frequent indications of corticosteroids are reviewed knowing that most of them are without an official market access labelling. Prescribing corticosteroids is always weighing the balance between benefits and risks mainly due to side effects and dependence.