[Glucocorticoid therapy in rheumatoid arthritis - pro]

Glucocorticoids are invaluable in the therapy of chronic-inflammatory diseases, like rheumatoid arthritis (RA). They act fast and efficient to suppress inflammation and serve to bridge the gap until disease modifying drugs (DMARD) show effect. However, the value of glucocorticoids with regard to their cost / benefit ratio in long term RA therapy is still controvers. In this short review, the main aspects favoring glucocorticoids as DMARD in long term RA therapy will be discussed. It becomes apparent, that at low dosage (prednisolone ≤ 5 mg / d), careful selection and monitoring of patients, and osteoporosis prophylaxis according to guidelines, long term therapy with glucocorticoids is an option and, with a favorable cost / benefit ratio, contributes to inflammation control and prevention of structural damage.