Continuing versus tapering steroids after achieving remission in RA, finds Lancet study
Is the long-term use of glucocorticoids essential in people with chronic inflammatory diseases such as rheumatoid arthritis, or can early discontinuation prevent characteristic side effects?
How can these drugs be discontinued without giving rise to glucocorticoid withdrawal syndrome? These were the questions addressed by the SEMIRA study, a large European trial led by Charité – Universitätsmedizin Berlin. According to the trial's findings, continuous glucocorticoid regimens were better at controlling disease activity. However, discontinuation also proved successful in the majority of cases, and could be used to prevent the long-term side effects associated with glucocorticoid treatment. Results from this trial have been published in The Lancet.*
In patients who achieved low disease activity with tocilizumab and at least 24 weeks of glucocorticoid treatment, continuing glucocorticoids at 5 mg per day for 24 weeks provided safe and better disease control than tapering glucocorticoids, although two-thirds of patients were able to safely taper their glucocorticoid dose.