Frank Buttgereit

TL;DR: Circadian rhythms in RA, dysfunction of the HPA axis in RA and other rheumatic diseases and the recent concept of the hepato-hypothalamic-pituitary-adrenal-renal axis are described, the problem of adrenal suppression by GC therapy and how it can be avoided, and evidence that chronotherapy with modified release prednisone effective at 02:00 a.m. can inhibit proinflammatory sequelae of nocturnal inflammation better compared with GC administration

TL;DR: The position and critically discuss the following products that are currently under development: (1) selective glucocorticoid receptor agonists (SEGRA or dissociating glucOCorticoids); (2) nitrosteroids; and (3) long-circulating liposomal glucoc Corticoids.

TL;DR: Clinical and patient-derived data from 10,068 outpatients with RA from the national database of the German Collaborative Arthritis Centres for the year 2001 collected by more than 80 rheumatologists in hospitals and private practices showed glucocorticoids play a pivotal role in the management of RA.

TL;DR: In inflamed joint tissue, the microvascular architecture is highly dysregulated; thus, efficiency of oxygen supply to the synovium is poor and invading cells must adapt instantaneously to changes in the oxygen level of the microenvironment.

TL;DR: Evidence to guide monitoring and treatment of patients with TAK is predominantly derived from observational studies with low level of evidence, therefore, higher-quality studies are needed in the future.