The place of corticosteroid therapy in the treatment of rheumatoid arthritis

Corticosteroids have been used to treat rheumatoid arthritis (RA) for over four decades. The history of their use is filled with ambivalence, mainly because of the well recognised adverse effects of chronic treatment. Whether used locally or systematically corticosteroids are highly effective anti-inflammatory agents in the treatment of synovitis However, recent evidence suggests that they may have a more important role in the treatment of RA by retarding disease progression. Better understanding of the mechanisms of action and use in smaller doses have justified this renewed interest in what has been, and arguably still is, the most important pharmacological tool we have to combat the morbidity and mortality associated with the many manifestations of rheumatoid arthritis.