Innovations in glucocorticoid therapy: from systemic action to precision medicine

Glucocorticoids are an essential treatment for inflammatory and autoimmune pathologies, but their long-term safety is limited by systemic toxicity and their non-specific action within the body. To overcome these clinical barriers, mo­dern medicine is transitioning toward precision phar­ma­co­lo­gy, aiming to clearly separate the anti-in­flam­ma­tory ef­fect from metabolic adverse reactions. In­no­vations in this field focus on three major directions: the development of selective glucocorticoid receptor modulators, the use of in­tra­cel­lu­lar delivery systems such as antibody-drug con­ju­gates and prodrugs strictly intended for target cells, and the application of chronotherapy to synchronize treatment ad­mi­nis­tra­tion with the biological rhythm of inflammation. The im­ple­men­ta­tion of these strategies allows for achieving ma­xi­mum therapeutic efficacy with minimal risk to the patient.