Glucocorticoids

Despite the continuing debate about the risks and benefits of glucocorticoids, their central role in the therapeutic armamentarium remains undisputed. Studies continue to unravel the complexity of their biologic effects on gene transcription, and careful clinical observation refines their therapeutic use. Although cloaked in controversy, some recent highlights include the possibility that high-dose intravenous methylprednisolone may affect the development of multiple sclerosis, the suggestion that prednisone may have little efficacy in the management of high-risk pregnancy in patients with antiphospholipid antibodies, and several observations that administration of calcium and vitamin D prevents bone loss in patients receiving steroids.