Lack of Information in Current Guidelines Regarding Systemic Corticosteroids in Inflammatory Diseases
Abstract
The use of systemic steroids for inflammatory diseases is a controversial issue—one that continuously invites disagreement throughout the healthcare community. However, there is little, if any, mention of systemic steroid recommendations among widely used rheumatoid arthritis, psoriasis, and psoriatic arthritis guidelines. This relative dearth of information is contrasted by the pervasive systemic steroid use for decades both domestically and abroad [1,2]. The European League Against Rheumatism (EULAR) guidelines for rheumatoid arthritis discuss systemic steroid use, though relatively briefly [3]. The most recent American Academy of Dermatology (AAD) psoriasis and American College of Rheumatology (ACR) rheumatoid arthritis guidelines fail to make any recommendations regarding systemic steroid use [4,5]. Currently, there is a void in guidelines regarding when and how (if at all) to use systemic steroids in psoriasis and there are minimal recommendations regarding psoriatic and rheumatoid arthritis. Considering how often primary care physicians, dermatologists, and rheumatologists prescribe systemic steroids for rheumatic diseases and psoriasis, this void must be filled.