TY - JOUR T1 - Efficacy and safety of glucocorticoids in rheumatoid arthritis: Systematic literature review JO - Reumatología Clínica (English Edition) T2 - AU - Sanmartí,Raimon AU - Tornero,Jesús AU - Narváez,Javier AU - Muñoz,Alejandro AU - Garmendia,Elena AU - Ortiz,Ana M. AU - Abad,Miguel Angel AU - Moya,Patricia AU - Mateo,María Lourdes AU - Reina,Delia AU - Salvatierra-Ossorio,Juan AU - Rodriguez,Sergio AU - Palmou-Fontana,Natalia AU - Ruibal-Escribano,Ana AU - Calvo-Alén,Jaime SN - 21735743 M3 - 10.1016/j.reumae.2018.06.004 DO - 10.1016/j.reumae.2018.06.004 UR - https://reumatologiaclinica.org/en-efficacy-safety-glucocorticoids-in-rheumatoid-articulo-S2173574319301169 AB - Objectives(1) To systematically and critically review the evidence on the characteristics, efficacy and safety of glucocorticoids (CS) in rheumatoid arthritis (RA); (2) to generate practical recommendations. MethodsA systematic literature review was performed through a sensitive bibliographic search strategy in Medline, Embase and the Cochrane Library. We selected randomized clinical trials that analyzed the efficacy and/or safety of CS in patients with RA. Two reviewers performed the first selection by title and abstract. Then 10 reviewers selected the studies after a detailed review of the articles and data collection. The quality of the studies was evaluated with the Jadad scale. In a nominal group meeting, based on the results of the systematic literature review, related recommendations were reached by consensus. ResultsA total of 47 articles were finally included. CS in combination with disease-modifying antirheumatic drugs help control disease activity and inhibit radiographic progression, especially in the short-to-medium term and in early RA. CS can also improve function and relieve pain. Different types and routes of administration are effective, but there is no standardized scheme (initial dose, tapering and duration of treatment) that is superior to others. Adverse events when using CS are very frequent and are dose-dependent and variable severity, although most are mild. Seven recommendations were generated on the use and risk management of CS. ConclusionsThese recommendations aim to resolve some common clinical questions and aid in decision-making for CS use in RA. ER -