Therapeutic glucocorticoids mechanisms of actions in rheumatic diseases

Research output: Contribution to journalReview articlepeer-review

Authors

External organisations

  • University of Sydney
  • ANZAC Research Institute
  • University of Sydney, Austria;

Abstract

Therapeutic glucocorticoids have been widely used in rheumatic diseases since they became available over 60 years ago. Despite the advent of more specific biologic therapies, a notable proportion of individuals with chronic rheumatic diseases continue to be treated with these drugs. Glucocorticoids are powerful, broad- spectrum anti- inflammatory agents, but their use is complicated by an equally broad range of adverse effects. The specific cellular mechanisms by which glucocorticoids have their therapeutic action have been difficult to identify, and attempts to develop more selective drugs on the basis of the action of glucocorticoids have proven difficult. The actions of glucocorticoids seem to be highly cell- type and context dependent. Despite emerging data on the effect of tissue- specific manipulation of glucocorticoid receptors in mouse models of inflammation, the cell types and intracellular targets of glucocorticoids in
rheumatic diseases have not been fully identified. Although showing some signs of decline, the use of systemic glucocorticoids in rheumatology is likely to continue to be widespread, and careful consideration is required by rheumatologists to balance the beneficial effects and deleterious effects of these agents.

Details

Original languageEnglish
Pages (from-to)133-144
Number of pages12
JournalNature Reviews Rheumatology
Volume16
Issue number3
Early online date7 Feb 2020
Publication statusPublished - Mar 2020

ASJC Scopus subject areas