摘要：糖皮质激素（简称激素）可快速缓解早期和进展期类风湿关节炎的病情活动。本系统综述的目的是为类风湿关节炎治疗使用激素提供建议。通过检索Medline、Embase、Cochrane数据库及ACR/EULAR2007年和2008年的摘要，寻找有关类风湿关节炎应用激素的论文。检索发现，总共有11本出版物（含3篇Cochrane综述，33个临床试验) 满足评估标准。得出如下结论： 激素作为“桥”治疗获得了强有利的证据。不管是标准非生物性DMARD单一还是联合用药，加激素有效，并可抑制放射学进展数年。在早期类风湿关节炎，DMARD联合小剂量激素(<7 .5 mg/day)可减慢放射学进展，而对于病程长的类风湿关节炎，最大量为15mg/d的激素也可改善病情活动性。还有一些证据显示，恰当地使用激素可使晨僵缩短。间接证据显示，激素应缓慢减量，防止病情复发。激素对减轻体征和症状有效，并抑制放射学进展，可单用或联合一种或多种非生物性dmard使用。.

附原文：Abstract Glucocorticoids (GCs) rapidly reduce disease activity in early and advanced rheumatoid arthritis (RA). This systematic review on behalf of the task force on recommendations for the management of RA addresses the efficacy of GCs in RA. A literature search was performed in Medline, Embase, the Cochrane database, and the ACR/EULAR abstracts 2007 and 2008 on a set of questions relating to the use of GCs in RA. Eleven publications (including three Cochrane reviews comprising 33 trials) that met the criteria for detailed assessment were found. Robust evidence that GCs are effective as bridging therapy was obtained. The addition of GCs, to either standard synthetic disease-modifying antirheumatic drug (DMARD) monotherapy or combinations of synthetic DMARDs, yields clinical benefits and inhibition of radiographic progression that may extend over many years. In early RA, the addition of low-dose GCs (<7 .5 mg/day) to dmards leads to a reduction in radiographic progression; in longstanding ra, gcs (up to 15 mg/day) improve disease activity. there is some evidence that appropriate timing of gc administration may result in less morning stiffness. only indirect information was found on the best tapering strategy, supporting the general view that gcs should be tapered slowly in order to avoid clinical relapses. gcs are effective in relieving signs and symptoms and inhibiting radiographic progression, either as monotherapy or in combination with synthetic dmard monotherapy or combination therapy.

引自Gorter SL, et al. Current evidence for the management of rheumatoid arthritis with glucocorticoids: a systematic literature review informing the EULAR recommendations for the management of rheumatoid arthritis.Ann Rheum Dis. 2010 Jun;69(6):1010-4.