[Glucocorticoid therapy in rheumatoid arthritis - contra]

Corticosteroids have a pleiotropic mechanism of action and influence a great number of cellular functions. This does not only result in a broad therapeutic effect, but in a large number of adverse events as well. It has been shown that about 60 % of all patients with rheumatoid arthritis in Germany are receiving corticosteroids and about every fifth of them more than the equivalence of 7.5 mg prednisone per day. Already small doses increase the risk f. e. for osteoporosis or cataract, as well as for severe infections. The benefit of a treatment with low dose corticosteroids in inhibiting the radiological erosivity of the disease is low and does not outweigh the risks.