The 70th Anniversary of Glucocorticoids in Rheumatic Diseases

The Second Youth of an Old Friend

Yannick Palmowski; Thomas Buttgereit; Frank Buttgereit


Rheumatology. 2019;58(4):580-587. 

In This Article


Seven decades ago, GCs provided us with the first effective weapon in the fight against rheumatic diseases. Since then, their presumed role has undergone multiple changes during the different epochs—particularly in RA, the originally targeted disease. After a short-lasting period of enthusiastic acclaim as a miracle drug, they spent several decades with little scientific attention, being considered mainly a treatment of last resort. During these eventful times they have always been reliable allies whenever needed, that is, when other (preferred) treatment options were insufficiently effective, unavailable or non-existent.

Today, GCs are still far from being obsolete. Recently they have received a more differentiated re-evaluation as a possible disease-modifying agent if co-administered at low doses. The steadily increasing acceptance of GCs is reflected in their consideration in all current guidelines for the pharmacological treatment of RA.[3] They remain among the most widely prescribed drugs and are included in the WHO Model List of Essential Medicines.[16,61] Furthermore, the research on new substances as well as the striving for a better understanding of the conventional agent are currently very active.

Therefore one could say that GCs are currently experiencing a second youth, and it will be interesting to see which turns their path will take in the future. But one thing is for sure: like an old friend, they will continue to keep us company in the ongoing fight against rheumatic and other inflammatory diseases for decades to come.