Corticosteroids are more potent than NSAIDs in reducing inflammation and restoring function when the disease is active. Corticosteroids are particularly helpful when internal organs are affected. Corticosteroids can be given by mouth, injected directly into the joints and other tissues, or administered intravenously. Unfortunately, corticosteroids have serious side effects when given in high doses over prolonged periods, and the doctor will try to monitor the activity of the disease in order to use the lowest doses that are safe. Side effects of corticosteroids include weight gain , thinning of the bones and skin, infection, diabetes , facial puffiness, cataracts , and death (necrosis) of the tissues in large joints.
The researchers note that consensus was reached on 12 statements, including that systemic corticosteroids should be avoided generally. In specific circumstances, systemic corticosteroids can be used rarely for severe atopic dermatitis, such as lack of other treatment options, as a bridge to other systemic therapies or phototherapy, during acute flares that need immediate relief, in anticipation of a major life event, or in the most severe cases. Treatment should be limited to short term, if used. Although most respondents agreed that systemic corticosteroids should never be used in children, consensus was not reached. A dearth of high-quality published evidence limited the conclusions of the expert group. Consensus would have been reached on fewer statements if more stringent consensus criteria were applied.