Low-dose prednisolone effective in patients with established rheumatoid arthritis: study

Results:

• The investigators randomized 451 patients with established RA and mean comorbidity of 2.1, 72 years of age, 11 years of disease duration, and DAS28 4.5. 79% were receiving disease-modifying therapy, 14% biologic. 63% of prednisolone and 61% of placebo patients completed the study.

• Interruptions were due to AE (both 14%), active disease (3% vs. 4%), and other (including covid pandemic-related disease) (19% vs. 21%); The average working time was 19 months.

• Disease activity was 0.37 points lower in prednisolone; joint damage progression was 1.7 points lower.

• 60% versus 49% of patients experienced a harm outcome with an adjusted relative risk of 1.24, with the greatest contrast (mostly non-severe) infections.

• Other GC-specific events were rare.

Therefore, additional low-dose prednisolone has long-term beneficial effects in elderly patients with established RA, mostly a tradeoff of 24% in patients with non-severe AE; this indicates a positive balance of benefit and harm.

Reference:

Boers M, Hartman L, Opris-Belinski D For the GLORIA Trial consortium, et alLow dose, add-on prednisolone in patients with rheumatoid arthritis aged 65+: the pragmatic randomised, double-blind placebo-controlled GLORIA trialAnnals of the Rheumatic Diseases 2022;81:925-936.

Keywords:

Low dose, add-on, prednisolone, patients, rheumatoid, arthritis, aged 65, pragmatic, randomised, double-blind, placebo-controlled, GLORIA, trial, Maarten Boers, Linda Hartman, Daniela Opris-Belinski, Reinhard Bos, Marc R Kok, Annals of the Rheumatic Diseases