After decades of sometimes fierce debate about the advantages and disadvantages of glucocorticoids, an age of convergence has been reached. Current recommendations for the management of diseases such as rheumatoid arthritis (RA), polymyalgia rheumatica and large vessel vasculitis reflect the current consensus that as much glucocorticoid as necessary, but as little as possible, should be used. Over the past few years, a range of glucocorticoid-sparing strategies have been developed, as have tools to improve the management of this therapy. A comprehensive view of glucocorticoid-induced osteoporosis has also emerged that recognizes that bone fragility is not solely determined by the dose and duration of glucocorticoid treatment. Nevertheless, open questions remain around whether long-term use of very low doses of glucocorticoids is a realistic option for patients with RA and whether the search for innovative glucocorticoids or glucocorticoid receptor ligands with improved benefit-to-risk ratios will ultimately be successful.

中文翻译：

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风湿病学中糖皮质激素治疗的观点：趋同年龄。

在数十年间关于糖皮质激素的优缺点的激烈辩论之后，已经到了一个融合的时代。当前对诸如类风湿性关节炎（RA），风湿性多肌痛和大血管血管炎等疾病的管理建议，反映了当前的共识，即应使用尽可能多的糖皮质激素，但应使用尽可能少的糖皮质激素。在过去的几年中，已经开发了多种糖皮质激素保留策略，以及改善该治疗方法的工具。还出现了对糖皮质激素引起的骨质疏松症的综合看法，认识到骨脆性不仅由糖皮质激素治疗的剂量和持续时间决定。不过，