ABSTRACT

Therapeutic use of corticosteroids is an important but controversial issue in

rheumatology. In 1949, Hench and others, who subsequently shared the Nobel

Prize for their pioneering work, demonstrated the dramatic effects of cortisone for

treating rheumatoid arthritis. Subsequent recognition of the side effects that may

develop from long-term use of supraphysiologic doses dampened enthusiasm for

its use. As late as the 1990s, corticosteroids were not universally recommended

for the treatment of crystal-induced arthritis because of fears of side effects and

concerns about rebound attacks of arthritis after the agents were discontinued.

Although controversies about the use of corticosteroids continue to this date,

these agents remain very effective treatments for many patients with serious

rheumatic diseases. In gout and the crystal-induced arthritides, corticosteroids are

potent and extremely useful therapeutic agents, and, in certain circumstances, are

the agents of choice.