{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T12:25:49Z","timestamp":1790252749054,"version":"4.1.0"},"reference-count":59,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T00:00:00Z","timestamp":1592179200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>In 1950, Hench, Kendall and Reichstein were awarded with the Nobel Prize in Physiology and Medicine for the isolation and first therapeutic use of glucocorticoids. Since then, they have become one of the main agents in the treatment of systemic lupus erythematosus (SLE). The use of high-dose oral glucocorticoids (usually 1\u2009mg\/kg\/day of prednisone equivalent) have become the rule for treating moderate to severe lupus activity. In addition, tapering schemes have not been well defined, all this leading to prolonged exposures to potentially damaging amounts of glucocorticoids. Several studies have shown that glucocorticoids are a major cause of toxicity in SLE in a dose-dependent manner, with prolonged doses greater than 7.5 mg\/day being associated with damage accrual. Thus, there is an urgent need for different therapeutic schedules that can achieve a rapid and durable control of lupus activity while reducing the many unwanted effects of glucocorticoids. Recent data show that pulses of methyl-prednisolone are an effective first-line therapy to treat lupus flares (not only severe ones) without major short or long-term toxicity and allowing a reduction in oral prednisone doses. Universal use of hydroxychloroquine \u2013 always recommended, infrequently accomplished \u2013 and early therapy with immunosuppressive drugs also help control SLE and reduce prednisone load. Results from observational studies confirm the more rapid achievement of remission and the reduction of long-term damage using these combination schedules with reduced prednisone doses. Seventy years after their first therapeutic use, we are learning to use glucocorticoids in a more efficient and safe manner.<\/jats:p>","DOI":"10.1177\/0961203320930099","type":"journal-article","created":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T23:32:34Z","timestamp":1592263954000},"page":"1155-1167","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":39,"title":["Seventy years after Hench\u2019s Nobel prize: revisiting the use of glucocorticoids in systemic lupus erythematosus"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7788-1043","authenticated-orcid":false,"given":"Guillermo","family":"Ruiz-Irastorza","sequence":"first","affiliation":[{"name":"Hospital Universitario Cruces, BioCruces Bizkaia Health Research Institute, University of the Basque Country, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaia","family":"Ugarte","sequence":"additional","affiliation":[{"name":"Hospital Universitario Cruces, BioCruces Bizkaia Health Research Institute, University of the Basque Country, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana","family":"Ruiz-Arruza","sequence":"additional","affiliation":[{"name":"Hospital Universitario Cruces, BioCruces Bizkaia Health Research Institute, University of the Basque Country, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munther","family":"Khamashta","sequence":"additional","affiliation":[{"name":"Department of Women and Children\u2019s Health, St Thomas Hospital, London"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,6,15]]},"reference":[{"key":"bibr1-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/ard.8.2.97"},{"key":"bibr2-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2015.08.001"},{"key":"bibr3-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.8.718"},{"key":"bibr4-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199805)41:5<761::AID-ART2>3.0.CO;2-M"},{"key":"bibr5-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra050541"},{"key":"bibr6-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.yfrne.2017.05.001"},{"key":"bibr7-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2012.11.005"},{"key":"bibr8-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.12364"},{"key":"bibr9-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1002\/art.20583"},{"key":"bibr10-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026445108136"},{"key":"bibr11-0961203320930099","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.170837"},{"key":"bibr12-0961203320930099","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.160214"},{"key":"bibr13-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-010-1597-9"},{"key":"bibr14-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2013.10.013"},{"key":"bibr15-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1007\/s11657-019-0667-1"},{"key":"bibr16-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22751"},{"key":"bibr17-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1002\/art.21984"},{"key":"bibr18-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2014-000066"},{"key":"bibr19-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu148"},{"key":"bibr20-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2000.15.6.993"},{"key":"bibr21-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90131-7"},{"key":"bibr22-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-014-0282-9"},{"key":"bibr23-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2015.10.002"},{"key":"bibr24-0961203320930099","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150460"},{"key":"bibr25-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws130"},{"key":"bibr26-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e4928"},{"key":"bibr27-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23322"},{"key":"bibr28-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1177\/0961203313493032"},{"key":"bibr29-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2008.07.010"},{"key":"bibr30-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1191\/0961203302lu170oa"},{"key":"bibr31-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1186\/ar2764"},{"key":"bibr32-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1002\/art.39070"},{"key":"bibr33-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-016-0673-8"},{"key":"bibr34-0961203320930099","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150671"},{"key":"bibr35-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.01.010"},{"key":"bibr36-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1177\/0961203318811598"},{"key":"bibr37-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1177\/0961203319860579"},{"key":"bibr38-0961203320930099","first-page":"1955","volume":"30","author":"Gladman DD","year":"2003","journal-title":"J Rheumatol"},{"key":"bibr39-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2016-000157"},{"key":"bibr40-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1177\/0961203317739129"},{"key":"bibr41-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200008)43:8<1801::AID-ANR16>3.0.CO;2-O"},{"key":"bibr42-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1191\/0961203302lu243oa"},{"key":"bibr43-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1177\/0961203318768888"},{"key":"bibr44-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1177\/0961203311418269"},{"key":"bibr45-0961203320930099","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.120537"},{"key":"bibr46-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202844"},{"key":"bibr47-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2015.05.011"},{"key":"bibr48-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/lupus-2016-000153"},{"key":"bibr49-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2017.05.017"},{"key":"bibr50-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.08.025"},{"key":"bibr51-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2019.102359"},{"key":"bibr52-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-216303"},{"key":"bibr53-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2017.11.002"},{"key":"bibr54-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21664"},{"key":"bibr55-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex286"},{"key":"bibr56-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-213512"},{"key":"bibr57-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215089"},{"key":"bibr58-0961203320930099","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-216924"},{"key":"bibr59-0961203320930099","unstructured":"Ruiz-Irastorza G, Ugarte A, Ruiz-Arruza I, et\u00a0al.\n                      Autoinmunes\n                      . Mobile App. Version 1.05. Osakidetza 2019. https:\/\/play.google.com\/store\/apps\/details?id=com.ionicframework.apautoinmunes2327096&gl=ES;https:\/\/apps.apple.com\/es\/app\/autoinmunes\/id1344571564 (accessed  1 March 2020)."}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0961203320930099","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0961203320930099","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0961203320930099","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:22:19Z","timestamp":1777677739000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0961203320930099"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,15]]},"references-count":59,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1177\/0961203320930099"],"URL":"https:\/\/doi.org\/10.1177\/0961203320930099","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,15]]}}}