The ACR/EULAR recommendations endorse the use of glucocorticoids (GCs) for rheumatoid arthritis (RA) patients' flares and as a bridge to a DMARD. However, the recommendation of low dose short-term monotherapy with glucocorticoids (GCs) remains open to the discretion of the clinician.
A group of researchers from U.S.A conducted a study to assess whether short-term use of low dose prednisone monotherapy was effective in inducing remission in newly diagnosed for rheumatoid arthritis (RA).
The researchers performed a retrospective analysis of patients newly diagnosed with rheumatoid arthritis (RA) at a Community Health Center in North Dakota was performed based on the ACR/EULAR RA classification criteria. Demographic and clinical data were abstracted from patients' medical charts. Patients treated with (< 10 mg/day) of prednisone up to 6 months were included. Response to prednisone was analyzed according to pre- and post-treatment DAS28-ESR score and EULAR response criteria.
The results of the study are as follows:
- Data on 201 patients were analyzed.
- The mean prednisone dose was 8 mg/day and the mean treatment duration was 42.2 days Disease severity significantly improved from baseline to follow-up for the tender joint count, swollen joint count, and visual analog pain score.
- DAS28-ESR disease severity significantly improved from baseline to follow-up.
- Per EULAR response criteria, 69.7% of patients showed good response to treatment and 20.4% showed a moderate response. 54.2% of patients reached remission.
Thus, the researchers concluded that short-term use of low dose prednisone monotherapy induced disease remission and improved clinical severity of rheumatoid arthritis in the majority of newly diagnosed patients.
Reference:
The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients by Stacy J et. al published in the Adv Rheumatol.
DOI: 10.1186/s42358-021-00205-4
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