**4.3 Other therapeutic advances**

Another interesting approach in the use of GC has been their use in combination with drugs that can amplify their intracellular effects at low doses. One approach looked at a preparation which combines low dose prednisolone in combination with dipyridamole (Kvien et al., 2008). This combination seemed to enhance the ability of GC to suppress the pro-inflammatory NFκB pathway (as mentioned in section 3.1) while sparing the genetranscription element of GC action which is associated with adverse effects. Other novel strategies involve targeting of the GC to the site of inflammation by encapsulating them in long-circulating liposomes (Schiffelers et al., 2006). This approach has shown promise in animal models of inflammatory arthritis but clinical studies are still lacking. These advances represent a potential new dawn for the use of GC in rheumatoid arthritis and have implications for a number of other inflammatory diseases.
