What are corticosteroids?
They are a class of drugs designed to be similar to the hormone cortisol, which is produced naturally by the body’s adrenal glands to regulate the immune system. They are sometimes referred to casually as steroids and some doctors call them by their more specific name: glucocorticoids. In contrast, anabolic steroids, most widely associated with athletes, are related to the hormone testosterone and have no role in arthritis treatment.
What diseases are they used for?
Corticosteroids are used to suppress inflammation of autoimmune diseases, including rheumatoid arthritis, lupus, vasculitis (for example, arteritis and Wegener’s granulomatosis), ankylosing spondylitis, polymyalgia rheumatica, psoriatic arthritis, reactive arthritis, scleroderma and Sjögren’s syndrome.
How are they used?
Corticosteroids are among the most effective drugs for relieving inflammation quickly and dramatically. They are used in high doses to reduce dangerous flares of inflammation – sometimes as a temporary measure, until other drugs take effect.
In low doses, they are used to prevent flares and protect joints, eyes and internal organs from damage caused by inflammation.
Corticosteroids sometimes are used with disease-modifying anti-rheumatic drugs (DMARDs), such as leflunomide (Arava), methotrexate or sulfasalazine (Azulfidine). Combination therapy can increase the effectiveness of very low doses of corticosteroids. They usually are not used in combination with biologic response modifiers, a new type of DMARD, such as abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), etanercept (Enbrel), infliximab (Remicade) and rituximab (Rituxan).
What forms of corticosteroids are available?
Corticosteroid medications typically are taken orally. The oral versions are the only ones listed in this Drug Guide.
Other corticosteroids are given intravenously when high doses are needed quickly for short periods of time.
Some forms of corticosteroids can be injected directly into joints for relief of pain and swelling. Cortisone shots commonly are used in osteoarthritis treatment. Those injections act locally, and so are not associated with systemic side effects. Topical corticosteroids are applied directly to the skin to relieve the inflamed skin lesions of cutaneous lupus erythematosus and psoriasis. If the topical corticosteroid is used over a wide area, systemic side effects may occur.
