Standardised nomenclature for glucocorticoid dosages and glucocorticoid treatment regimens: current questions and tentative answers in rheumatology
Open accessAbstract
In rheumatology and other medical specialties there is a discrepancy between the widespread use and the imprecise designation of glucocorticoid treatment regimens. Verbal descriptions of glucocorticoid treatment regimens used in various phases of diseases vary between countries and institutions. Given this background, a workshop under the auspices of the EULAR Standing Committee on International Clinical Studies including Therapeutic Trials was held to discuss this issue and to seek a consensus on nomenclature for glucocorticoid treatment. This report summarises the panel's discussion and recognises that answers derived from consensus conferences are not definitive. Nevertheless, recommendations on glucocorticoid treatment are presented that (1) reflect current and best knowledge available and (2) take into account current clinical practice. A question-answer rationale presentation style has been chosen to convey the messages, to summarise the meeting in a readable format, and to avoid dogmatism.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The efficacy of low-dose GCs (≤7.5 mg prednisolone equivalent daily) on disease activity in various conditions is well established.
“Although the efficacy of these doses on disease activity in various conditions is well established [1–4, 7]”
From Low-dose glucocorticoid treatment affects multiple aspects of intermediary metabolism in healthy humans: a randomised controlled trial (2011) · cites this paper as [7]
The Low dose section (page unavailable) says that doses below 7.5 mg prednisone equivalent daily are often used for maintenance therapy in many rheumatic diseases. It does not establish their efficacy on disease activity across various conditions; the explicit statement about effectiveness in various rheumatic conditions appears in the Medium dose section and concerns doses above 7.5 mg. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe development of these adverse metabolic effects is dependent on the administered dose, and has mainly been studied with high doses.
“The development of these adverse metabolic effects is dependent on the administered dose [7], and has mainly been studied with high doses.”
From Low-dose glucocorticoid treatment affects multiple aspects of intermediary metabolism in healthy humans: a randomised controlled trial (2011) · cites this paper as [7]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Goodman and Gilman's the Pharmacological Basis of Therapeutics
Stigelman, W. H., & Pharm, D. (1986) · Military Medicine · doi:10.1093/milmed/151.1.386 · Cited by 6,796 · see citing works
Tsokos, G. C. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-37754-6.50094-4 · Cited by 3,990 · see citing works
Boers, M., Verhoeven, A. C., Markusse, H. M., van de Laar, M. A., Westhovens, R., van Denderen, J. C., van Zeben, D., Dijkmans, B. A. C., Peeters, A. J., Jacobs, P., et al. (1997) · The Lancet · doi:10.1016/s0140-6736(97)01300-7 · Cited by 1,073 · see citing works
Self-citationThe Effect of Glucocorticoids on Joint Destruction in Rheumatoid Arthritis
Kirwan, J. R. (1995) · New England Journal of Medicine · doi:10.1056/nejm199507203330302 · Cited by 817 · see citing works
Self-citationvan Everdingen, A. A., Jacobs, J. W. G., van Reesema, D. R. S., & Bijlsma, J. W. J. (2002) · Annals of Internal Medicine · doi:10.7326/0003-4819-136-1-200201010-00006 · Cited by 488 · see citing works
Self-citationRapid glucocorticoid effects on immune cells
Buttgereit, F., & Scheffold, A. (2002) · Steroids · doi:10.1016/s0039-128x(01)00171-4 · Cited by 318 · see citing works
Self-citationBoumpas, D. T., Austin, H. A., Fessler, B. J., Balow, J. E., Klippel, J. H., & Lockshin, M. D. (1995) · Annals of Internal Medicine · doi:10.7326/0003-4819-122-12-199506150-00009 · Cited by 302 · see citing works
Bioenergetics of immune functions: fundamental and therapeutic aspects
Buttgereit, F., Burmester, G. R., & Brand, M. D. (2000) · Immunology Today · doi:10.1016/s0167-5699(00)01593-0 · Cited by 284 · see citing works
Self-citation(1999) · PubMed · Cited by 139 · see citing works
Behrend, E. N., & Kemppainen, R. J. (1997) · Veterinary Clinics of North America Small Animal Practice · doi:10.1016/s0195-5616(97)50027-1 · Cited by 110 · see citing works
Therapeutic implications of non-genomic glucocorticoid activity
Lipworth, B. J. (2000) · The Lancet · doi:10.1016/s0140-6736(00)02463-6 · Cited by 101 · see citing works
Schmid, D., Burmester, G. R., Tripmacher, R., et al. (2000) · Bioscience Reports · doi:10.1023/a:1026445108136 · Cited by 87 · see citing works
Self-citationJacobs, J. W. G., Geenen, R., Evers, A. W. M., et al. (2001) · Annals of the Rheumatic Diseases · doi:10.1136/ard.60.1.61 · Cited by 48 · see citing works
Self-citationNeuropsychiatric systemic lupus erythematosus
Navarrete, M. G., & Brey, R. L. (2000) · Current Treatment Options in Neurology · doi:10.1007/s11940-000-0045-7 · Cited by 39 · see citing works
Management of systemic vasculitis
Langford, C. A. (2001) · Best Practice & Research Clinical Rheumatology · doi:10.1053/berh.2001.0144 · Cited by 33 · see citing works
OPTIMIZING GLUCOCORTICOID THERAPY IN RHEUMATOID ARTHRITIS
António, P. D. S. J., & Bijlsma, J. W. J. (2000) · Rheumatic Disease Clinics of North America · doi:10.1016/s0889-857x(05)70173-3 · Cited by 28 · see citing works
Self-citationCorticosteroids in polymyalgia rheumatica--a review of different treatment schedules.
Li, C., & Dasgupta, B. (2000) · PubMed · Cited by 22 · see citing works
Neuropsychiatric systemic lupus erythematosus
Sibbitt, W. L., Jung, R. E., & Brooks, W. M. (1999) · Comprehensive Therapy · doi:10.1007/bf02889620 · Cited by 19 · see citing works
Systemic lupus erythematosus—management
Dey, I. D., & Isenberg, D. A. (2016) · Oxford University Press eBooks · doi:10.1093/med/9780199642489.003.0118_update_003 · Cited by 4 · see citing works
Systemic lupus erythematosus—management
Dey, I. D., & Isenberg, D. A. (2013) · Oxford University Press eBooks · doi:10.1093/med/9780199642489.003.0118_update_002 · Cited by 1 · see citing works
Straub, R. H., & Cutolo, M. (2001) · Arthritis & Rheumatism · doi:10.1002/1529-0131(200103)44:3
Self-citationLawrence (1998) · doi:10.1002/1529-0131(199805)41:5
Flagged first, then by citations
Research works printed but not linked: 2
- Buttgereit F, Wehling M, Burmester GR. A new hypothesis of modular glucocorticoid actions. Glucocorticoid treatment of rheumatic diseases revisited. Arthritis Rheum 1998;41:761-67.
- Buttgereit F, Burmester GR, Brand MD. Bioenergetics of immune functions: the power that drives immunity. Immunology Today 2000;21:192-9.
Cited by
Sorted by citations
2019 update of the EULAR recommendations for the management of systemic lupus erythematosus
Fanouriakis, A., Kostopoulou, M., Alunno, A., Aringer, M., Bajema, I., Boletis, J. N., Cervera, R., Doria, A., Gordon, C., Govoni, M., et al. (2019) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2019-215089 · Cited by 2,011 · see citing works
Pharmacokinetics and pharmacodynamics of systemically administered glucocorticoids.
Czock, D., Keller, F., Rasche, F. M., & H??ussler, U. (2005) · Clinical Pharmacokinetics · doi:10.2165/00003088-200544010-00003 · Cited by 886 · see citing works
Genomic and nongenomic effects of glucocorticoids
Stahn, C., & Buttgereit, F. (2008) · Nature Clinical Practice Rheumatology · doi:10.1038/ncprheum0898 · Cited by 594 · see citing works
Dose-related patterns of glucocorticoid-induced side effects
Huscher, D., Thiele, K., Gromnica-Ihle, E., Hein, G., Demary, W., Dreher, R., Zink, A., & Buttgereit, F. (2009) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2008.092163 · Cited by 604 · see citing works
Self-citationMolecular mechanisms of glucocorticoid action and selective glucocorticoid receptor agonists
Stahn, C., Löwenberg, M., Hommes, D. W., & Buttgereit, F. (2007) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2007.05.019 · Cited by 419 · see citing works
Self-citationGlucocorticoids—All-Rounders Tackling the Versatile Players of the Immune System
Strehl, C., Ehlers, L., Gaber, T., & Buttgereit, F. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.01744 · Cited by 308 · see citing works
Self-citationAdverse events of low- to medium-dose oral glucocorticoids in inflammatory diseases: a meta-analysis
Hoes, J. N., Jacobs, J. W. G., Verstappen, S. M. M., Bijlsma, J. W. J., & Van der Heijden, G. J. M. G. (2009) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2008.100008 · Cited by 243 · see citing works
Self-citationOptimized glucocorticoid therapy: teaching old drugs new tricks
Strehl, C., & Buttgereit, F. (2013) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2013.01.026 · Cited by 118 · see citing works
Self-citationvan Raalte, D. H., Brands, M., van der Zijl, N. J., Muskiet, M. H., Pouwels, P. J. W., Ackermans, M. T., Sauerwein, H. P., Serlie, M. J., & Diamant, M. (2011) · Diabetologia · doi:10.1007/s00125-011-2174-9 · Cited by 109 · see citing works
High dose methylprednisolone therapy for the treatment of severe systemic lupus erythematosus
Parker, B., & Bruce, I. (2007) · Lupus · doi:10.1177/0961203307079502 · Cited by 80 · see citing works
Management of Glucocorticoid-Induced Hyperglycemia
Shah, P., Kalra, S., Yadav, Y., Deka, N., Lathia, T., Jacob, J. J., Kota, S. K., Bhattacharya, S., Gadve, S. S., Subramanium, K., et al. (2022) · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy · doi:10.2147/dmso.s330253 · Cited by 80 · see citing works
Li, X., Liang, T., Dai, B., Chang, L., Zhang, Y., Hu, S., Guo, J., Xu, S., Zheng, L., Yao, H., et al. (2024) · Journal of Clinical Investigation · doi:10.1172/jci166795 · Cited by 41 · see citing works
- Authors
- Buttgereit, F., Da Silva, J. A. P., Boers, M., Burmester, G.-R., Cutolo, M., Jacobs, J., Kirwan, J., Köhler, L., van Riel, P., Vischer, T., & Bijlsma, J. W. J.
- Affiliations
- Humboldt-Universität zu Berlin (DE)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- University of Genoa (IT)
- University Medical Center Utrecht (NL)
- University of Bristol (GB)
- Medizinische Hochschule Hannover (DE)
- University Hospital of Geneva (CH)
- Corresponding author
- Buttgereit, F
- Venue
- Annals of the Rheumatic Diseases
- Publisher
- Elsevier BV
- Published
- 2002-08
- Volume
- 61
- Issue
- 8
- Pages
- 718-722
- ISSN
- 0003-4967 (ISSN-L)
- OpenAlex
- W2137953708
- Cited by
- 544
- References
- 22
- Citations by year
- 2026: 21 · 2025: 27 · 2024: 49 · 2023: 50 · 2022: 33 · 2021: 45 · 2020: 42 · 2019: 34 · 2018: 23 · 2017: 22 · 2016: 16 · 2015: 19 · 2014: 20 · 2013: 20 · 2012: 13
- FWCI
- 4.60
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of the Rheumatic Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Funders
- Merck KGaA
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Rehabilitation › Musculoskeletal Disorders and Rehabilitation
- Keywords
- glucocorticoids, glucocorticoid dose, treatment regimens, rheumatic diseases, EULAR, consensus recommendations, clinical practice
- MeSH terms
- Drug Administration Schedule, Glucocorticoids, Humans, Terminology as Topic, Rheumatic Diseases, Rheumatology, Substance-Related Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
