Selective glucocorticoid receptor agonists: Glucocorticoid therapy with no regrets?

摘要

Therapeutic glucocorticoids were first developed in the 1950s to treat rheumatoid arthritis.'1' Since then the use of these potent anti-inflammatory drugs has expanded dramatically and they are now used in almost all areas of medical practice. Epidemiological surveys estimate that approximately 1 % of the population are on long-term glucocorticoid therapy, a figure that rises to almost 3% in the elderly.'2' Regrettably, the beneficial effects of glucocorticoids are almost always compromised by numerous adverse effects, collectively referred to as Cushing's syndrome. The most prominent features are skin atrophy, myopathy, central obesity, glucose intolerance and diabetes, and severe damage to bone including osteoporosis and osteonecrosis.