Covers use of corticosteroids to treat rheumatoid arthritis. Lists generic and brand names such as triamcinolone (Aristospan) and prednisolone. Looks at how well they work. Lists possible side effects when corticosteroids are used for a long time.
These medicines can be taken by mouth (orally). Shots (injections) of steroids into the joint may be used to relieve pain and swelling in a joint.
How It Works
Corticosteroids are medicines similar to natural hormone substances produced by the body that help to reduce inflammation. They are effective in reducing disease activity in rheumatoid arthritis.
One way corticosteroids reduce inflammation is by decreasing the action of the body's immune response. Although this effect can help relieve pain and swelling, it may make you more susceptible to infection.
Why It Is Used
Corticosteroids are used to control inflammation caused by rheumatoid arthritis.
Corticosteroids are used:
In low doses to control inflammation as "bridge therapy" when starting disease-modifying antirheumatic drugs (DMARDs) until the DMARDs become effective.
To treat sudden flares of joint pain.
For short-term relief (weeks to months) in inflamed joints.
In low doses for longer periods, for people who do not respond to other DMARDs.
For severe symptoms such as inflammation of the sac around the heart (pericarditis) or the blood vessels (vasculitis).
How Well It Works
Use of corticosteroids has been found to be effective in reducing inflammation caused by rheumatoid arthritis. Corticosteroids are usually used at the lowest dose and for the shortest amount of time possible.1
Corticosteroid shots into inflamed joints can relieve pain and increase function for some people. This relief may last from weeks to months.2 In general, the same joint should not be injected more than once every 3 or 4 months.
Serious side effects often occur when corticosteroids are used for long periods of time. These include:
Uncommon and irreversible (permanent) side effects, such as:
Softening or destruction of the hip, knee, wrist, or foot joint (osteonecrosis).
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Long-term use of corticosteroids is not recommended because of their serious side effects.
To prevent osteoporosis while taking long-term corticosteroids, get plenty of calcium and vitamin D, and consider a preventive medicine, such as alendronate or risedronate. To come up with a plan that fits your needs, you may want to work with your doctor or a registered dietitian. Weight-bearing exercise also helps reduce the risk of osteoporosis. For more information, see the topic Osteoporosis.
Lipsky PE (2008). Rheumatoid arthritis. In AS Fauci et al., eds., Harrison's Principles of Internal Medicine, 17th ed., vol. 2, pp. 2083–2092. New York: McGraw-Hill.
Firestein GS (2007). Rheumatoid arthritis. In DC Dale, DD Federman, eds., ACP Medicine, section 15, chap. 2. New York: WebMD.
The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.