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Semin Arthritis Rheum. 2019 Oct;49(2):251-259. doi: 10.1016/j.semarthrit.2019.03.010. Epub 2019 Mar 16.

Glucocorticoids pharmacology and their application in the treatment of childhood-onset systemic lupus erythematosus.

Author information

1
Department of Rheumatology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56 Nanlishi Road, Xicheng District, Beijing 100045, China; Division of Rheumatology, Cincinnati Children's Hospital Medical Center, MLC 4010, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
2
Division of Immunology, Allergy, and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
3
Division of Clinical Pharmacology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA.
4
Department of Rheumatology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, No. 56 Nanlishi Road, Xicheng District, Beijing 100045, China. Electronic address: caifeng_li@yeah.net.
5
Division of Rheumatology, Cincinnati Children's Hospital Medical Center, MLC 4010, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. Electronic address: Hermine.Brunner@cchmc.org.

Abstract

Glucocorticoids are potent anti-inflammatory and immunosuppressant medications and remain the mainstay of systemic lupus erythematosus (SLE) therapy. The potency of a specific glucocorticoid, i.e., the dose of glucocorticoid that is required to produce a specific effect, is dependent on its pharmacokinetic (PK) and pharmacodynamic (PD) properties. In this review, we summarize the PK/PD properties of commonly used glucocorticoids in an attempt to better delineate their role in the management of children with childhood-onset SLE (cSLE). We also address glucocorticoid side effects as these play a major role when deciding on the dose, frequency, and duration of use. A better understanding of the pharmacology of glucocorticoids appears useful to achieve improved outcomes in the management of cSLE.

KEYWORDS:

Childhood-onset systemic lupus erythematosus; Glucocorticoids; Pharmacodynamics; Pharmacokinetics

PMID:
30987856
PMCID:
PMC6744986
[Available on 2020-10-01]
DOI:
10.1016/j.semarthrit.2019.03.010

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