Glucocorticoids are one of the most important drugs in the treatment of systemic rheumatic diseases, especially for patients with critical conditions, and can have the miraculous effect of saving lives, reversing the disease and saving lives. For patients with moderate disease or above, they can also play a role in stopping the further deterioration of the disease and providing rapid relief. However, due to the prevalence of some unscientific and inappropriate indiscriminate use of hormones, many patients have experienced various side effects related to hormones, and hormones have become a “rat in the street, everyone shouting”. This has caused irreversible damage. Hormones are a “double-edged sword”. If they are used scientifically and reasonably, not only will they not cause obvious side effects, but on the contrary, they can play a very obvious therapeutic role, enabling patients’ conditions to be controlled quickly until they are cured. Only when used improperly, there will be various adverse reactions that should not occur. With the continuous development of medicine, a large number of clinical research results continue to guide rheumatologists to improve their treatment methods, and the use of hormones tends to be more reasonable. For example, the treatment process of rheumatoid arthritis has undergone decades of optimization and changes, and it is gradually accepted internationally that small doses of hormones can provide rapid relief of joint swelling and pain and play a “bridging” role for patients with high activity and refractory disease. Once these drugs start to take effect after 1-3 months, the hormones will be gradually reduced and discontinued. With such use, patients not only do not experience the side effects of hormones, but also their condition is effectively controlled in the shortest possible time, which is currently the main method of treatment in rheumatology. Of course, this involves a lot of detailed assessment of the individual patient’s condition, and the rational use of slow-acting anti-rheumatic drugs is a very specialized issue that depends on the rheumatologist’s rich clinical experience and high technical level. Similarly, other systemic rheumatic diseases such as systemic lupus erythematosus, dry syndrome, inflammatory myopathy, vasculitis, etc. have the same treatment concept. Hormones are the fastest-acting anti-rheumatic drugs, and other immunosuppressive drugs, also known as slow-acting anti-rheumatic drugs, are so named because of their slow onset of action. Therefore, the combination of drugs with different onset of action is like a relay race. Once the slow-acting drugs are fully effective and the patient’s condition is effectively controlled, the fast-acting hormones should be gradually withdrawn, leaving the slow-acting anti-rheumatic drugs with small side effects and definite efficacy for long-term maintenance so that the condition does not recur, which is the optimal individual treatment. Therefore, for most patients, hormones can be completely discontinued. Clinically, we often see that many patients’ treatment is exactly the opposite, because the treatment plan is not standardized and unreasonable, and there is a lack of effective slow-acting anti-rheumatic drugs, so patients can only rely on hormones to control their disease all year round, and even some patients with not serious disease blindly add hormones because they are worried about the recurrence of their disease. The body shows various manifestations of hormone side effects, such as compression fractures, metabolic disorders, secondary infections, etc., which are regrettable for life. Therefore, it is recommended that patients with rheumatic diseases go to an experienced rheumatology department as early as possible to develop a reasonable treatment plan. Of course, for a small number of patients with heavy, stubborn and recurrent diseases, it is very easy to relapse when the hormone is reduced to a small dose, and it is very difficult for these patients to stop using hormone, so it is necessary for both doctors and patients to patiently and carefully adjust the medicine to the best condition. This is the strategy of individualized treatment of rheumatic diseases, which uses the “least amount of drugs” and the “smallest amount of drugs” to solve the “biggest problems” of patients.