Glukokortikoid-Therapie bei rheumatoider Arthritis – Pro

Zusammenfassung

Glukokortikoide haben in der Therapie chronisch-entzündlicher Erkrankungen, wie der rheumatoiden Arthritis (RA), einen unumstrittenen Stellenwert zur schnellen und effektiven Unterdrückung der Entzündung und zur Überbrückung, bis andere krankheitsmodifizierende Medikamente (DMARD) greifen. Der Stellenwert von Glukokortikoiden bzgl. deren Kosten / Nutzen in der Dauertherapie der RA ist aber kontrovers. In diesem kurzen Überblick sollen die wesentlichen Argumente aufgeführt werden, die einen Einsatz von Glukokortikoiden im Sinne eines DMARD in der Dauertherapie unterstützen. Es zeigt sich, dass bei niedriger Dosierung (Prednisolon ≤ 5 mg / Tag), sorgfältiger Auswahl und Überwachung der Patienten sowie leitliniengerechter Osteoporoseprophylaxe auch eine Dauertherapie mit Glukokortikoiden möglich ist und mit einem guten Kosten / Nutzen-Verhältnis dazu beiträgt, Entzündung zu kontrollieren und strukturelle Schäden zu vermeiden.

Abstract

Glucocorticoids are invaluable in the therapy of chronic-inflammatory diseases, like rheumatoid arthritis (RA). They act fast and efficient to suppress inflammation and serve to bridge the gap until disease modifying drugs (DMARD) show effect. However, the value of glucocorticoids with regard to their cost / benefit ratio in long term RA therapy is still controvers. In this short review, the main aspects favoring glucocorticoids as DMARD in long term RA therapy will be discussed. It becomes apparent, that at low dosage (prednisolone ≤ 5 mg / d), careful selection and monitoring of patients, and osteoporosis prophylaxis according to guidelines, long term therapy with glucocorticoids is an option and, with a favorable cost / benefit ratio, contributes to inflammation control and prevention of structural damage.

Schlüsselwörter

niedrig dosierte Glukokortikoidtherapie - Rheumatoide Arthritis - DMARD

Keywords

low-dose glucocorticoid therapy - rheumatoid arthritis - DMARD

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