Endocrine: Corticosteroids, inflammatory disorders

Question 1

Use of which corticosteroid may reduce the rate of joint destruction in moderate to severe RA of less than 2 years’ duration?

Answer 1

Prednisolone.

Avoid increasing above 7.5mg daily.

Evidence supports maintenance of this anti-erosive dose for 204 years only after which treatment should be tapered off to reduce the long-term adverse effects: see osteoporosis etc.

Question 2

Polymyalgia rheumatica and giant cell (temporal) arteritis are always treated with what?

Answer 2

Corticosteroids.
Relapse is common if therapy is stopped prematurely. Many patients require treatment for at least 2 years and in some patients it may be necessary to continue long-term low-dose corticosteroid treatment.

Question 3

SLE is treated with corticosteroids when necessary. What condition is not?

Answer 3

Ankylosing spondylitis should not be treated with long-term corticosteroids; rarely, pulse doses may be needed and may be useful in extremely active disease that does not respond to conventional treatment.

Question 4

What corticosteroid is generally used for local injection of inflammatory conditions of the joints, particularly in RA?

Answer 4

Hydrocortisone acetate or one of the synthetic analogues.

Question 5

Each joint should not usually be treated with an injection of corticosteroid more than how often?

Answer 5

4 times a year.