Long-term treatment with low dose glucocorticoids in Rheumatoid Arthritis: New tricks of an old drug

Glucocorticoids (GC) have been used for more than 70 years in the management of rheumatoid arthritis (RA). The immediate improvement of the clinical picture is one of their main advantages. However, RA is a chronic disease and unfortunately, long-term GC administration is associated with several serious adverse events. This is the major reason why GC therapy should be administered for the shortest possible period of time, with tapering as far as it is feasible. Although this is accepted as a “dogma”, there is recently growing evidence suggesting that low doses, even in the long-term, might not be as dangerous as previously believed. On the contrary, GC may be beneficial for RA patients in several ways, considering their protective role in radiographic progression or lymphoma development.