Orale Glukokortikoide

Freier, D.; Strehl, Cindy; Buttgereit, Frank

doi:10.1007/s00105-020-04543-0

Cited by 2 publications

(5 citation statements)

References 54 publications

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“…They form a complex with the cytosolic GC-receptor, and the hormone-receptor complex binds to specific DNA sites causing "transactivation". This results in an increased synthesis of anti-inflammatory proteins such as IL-10, annexin-1, or inhibitors of nuclear factor Kappa B (NFκB) [15,19]. Of note, transactivation is (possibly oversimplistically) responsible for most GC-associated AEs [17,19,20].…”

Section: Genomic…mentioning

confidence: 99%

“…This results in an increased synthesis of anti-inflammatory proteins such as IL-10, annexin-1, or inhibitors of nuclear factor Kappa B (NFκB) [15,19]. Of note, transactivation is (possibly oversimplistically) responsible for most GC-associated AEs [17,19,20]. At the same time, the hormone-receptor complex inhibits pro-inflammatory transcription factors causing "transrepression", e.g., inactivation of NFκB [17].…”

Section: Genomic…mentioning

confidence: 99%

“…Non-genomic effects are mainly mediated by nonspecific interactions with cellular membranes, specific interactions with membrane-bound GC-receptors, and further effects mediated by the cytosolic GC-receptor [16][17][18]. Compared with the genomic effects outlined above, nongenomic effects (a) appear more quickly (seconds-minutes) [15,19], (b) come into play only at high dosages (beginning at approximately ≥ 30-100 mg/day prednisone equivalent) [17,20], and (c) do not have such strong "ceiling effects" [18,20]. Non-genomic effects are especially desired in acute situations, e.g., in anaphylaxis or complicated GCA [19].…”

Section: Genomic…mentioning

confidence: 99%

“…Compared with the genomic effects outlined above, nongenomic effects (a) appear more quickly (seconds-minutes) [15,19], (b) come into play only at high dosages (beginning at approximately ≥ 30-100 mg/day prednisone equivalent) [17,20], and (c) do not have such strong "ceiling effects" [18,20]. Non-genomic effects are especially desired in acute situations, e.g., in anaphylaxis or complicated GCA [19].…”

Section: Genomic…mentioning

confidence: 99%

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Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis

Palmowski

Buttgereit

2020

Curr Rheumatol Rep

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Purpose While glucocorticoids (GCs) are effective in large vessel vasculitis (LVV), they may cause serious adverse events (AEs), especially if taken for longer durations and at higher doses. Unfortunately, patients suffering from LVV often need long-term treatment with GCs; therefore, toxicity needs to be expected and countered. Recent Findings GCs remain the mainstay of therapy for both giant cell arteritis and Takayasu arteritis. In order to minimize their toxicity, the following strategies should be considered: GC tapering, administration of conventional synthetic (e.g., methotrexate) or biologic (e.g., tocilizumab) GC-sparing agents, as well as monitoring, prophylaxis, and treatment of GC-related AEs. Several drugs are currently under investigation to expand the armamentarium for the treatment of LVV. Summary GC treatment in LVV is effective but associated with toxicity. Strategies to minimize this toxicity should be applied when treating patients suffering from LVV.

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Section: Genomic…mentioning

confidence: 99%

Section: Genomic…mentioning

confidence: 99%

Section: Genomic…mentioning

confidence: 99%

Section: Genomic…mentioning

confidence: 99%

See 2 more Smart Citations

Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis

Palmowski

Buttgereit

2020

Curr Rheumatol Rep

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“…In total, there are 150 classified diseases of rheumatic disease with clinical picture, treatment and prognosis. Treatment is essential to identify any disease and its changes [7,8]. The prevalence of rheumatic diseases changes over time.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2021

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Rheumatic diseases are among the most health problems that exert economic and social burden on the general population. Patients' information based on the inclusion criteria were collected from hospital records in separate questionnaires, that were assessed in terms of age at the time of referral, sex, ethnicity, initial clinical manifestations, involved joints, presence of comorbid disease and extra-articular involvement. The study population was 3049 patients. The mean age of patients was 52.24 ± 12.99 years. 81 % of the patients were female. The prevalence of osteoporosis (OP) was 22.00%, Rheumatoid arthritis (RA) was 21.51%, and Osteoarthritis (OA) was 16.59%. Joint pain (OR 4.21, 95% CI 3.02-4.81, p < 0.001), BMI>25 (OR 3.83, 95% CI 2.01-6.79, p < 0.001), and Lack of physical activity (OR 2.34, 95% CI 1.14-3.75, p = 0.018) were risk factors of osteoporosis. It is recommended to control the known risk factors associated with these diseases, such as lifestyle modifications, and regular and effective exercise, as well as to review the associated risk factors, especially in women.

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Orale Glukokortikoide

Cited by 2 publications

References 54 publications

Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis

Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis

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