Glucocorticoids: Action and new therapeutic insights in rheumatoid arthritis

PURPOSE OF REVIEW: To summarize the mechanism of action of glucocorticoids, the direction that current research is taking and what this might mean for clinicians. RECENT FINDINGS: New cellular actions of glucocorticoids have been identified, and offer new drug targets. There is increasing competition to find a glucocorticoid formulation or analogue that enhances therapeutic effects while reducing adverse effects. Clinically, there is increasing evidence for the disease-modifying effects of glucocorticoids, which makes these developments topical and relevant. Better understanding of the pathology of rheumatoid arthritis and the circadian variation in symptoms that is a hallmark of the disease may also affect the way that we use these drugs. SUMMARY: Glucocorticoids are about to enter a renaissance based on better understanding of how they work and novel approaches to new therapeutic targets.