糖皮质激素（GC）具有抗炎、抗毒素、免疫抑制等广泛药理作用，在临床上广泛用于治疗红斑狼疮、肾炎、关节炎、溃疡性结肠炎、哮喘、角膜炎、黄斑水肿等多种疾病。和白血病。但长期使用往往会引起不良副作用，包括代谢紊乱引起的库欣综合征（水牛背、满月脸、高血糖等）、骨质疏松、感染加重、精神病、青光眼、白内障等。这些臭名昭著的副作用严重影响患者的生活质量，尤其是慢性病患者。因此，以糖皮质激素为基础的减少不良反应的先进给药系统受到了广泛的关注。其中，前药具有投资少、风险低、成功率高等优点，是一种颇具前景的策略。在这篇综述中，我们提出了设计策略并总结了近几十年来基于糖皮质激素的前药的研究进展，包括基于聚合物的前药、基于树枝状聚合物的前药、抗体-药物缀合物、肽-药物缀合物、基于碳水化合物的前药、脂肪酸类前药等。此外，我们还提出了糖皮质激素前药开发过程中需要关注的问题。本综述预计将对新型GC和前药的研发有所帮助。© 2024 沉阳药科大学。由 Elsevier B.V. 出版

Attributing to their broad pharmacological effects encompassing anti-inflammation, antitoxin, and immunosuppression, glucocorticoids (GCs) are extensively utilized in the clinic for the treatment of diverse diseases such as lupus erythematosus, nephritis, arthritis, ulcerative colitis, asthma, keratitis, macular edema, and leukemia. However, long-term use often causes undesirable side effects, including metabolic disorders-induced Cushing's syndrome (buffalo back, full moon face, hyperglycemia, etc.), osteoporosis, aggravated infection, psychosis, glaucoma, and cataract. These notorious side effects seriously compromise patients' quality of life, especially in patients with chronic diseases. Therefore, glucocorticoid-based advanced drug delivery systems for reducing adverse effects have received extensive attention. Among them, prodrugs have the advantages of low investment, low risk, and high success rate, making them a promising strategy. In this review, we propose the strategies for the design and summarize current research progress of glucocorticoid-based prodrugs in recent decades, including polymer-based prodrugs, dendrimer-based prodrugs, antibody-drug conjugates, peptide-drug conjugates, carbohydrate-based prodrugs, aliphatic acid-based prodrugs and so on. Besides, we also raise issues that need to be focused on during the development of glucocorticoid-based prodrugs. This review is expected to be helpful for the research and development of novel GCs and prodrugs.© 2024 Shenyang Pharmaceutical University. Published by Elsevier B.V.