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Moderate-term, low-dose corticosteroids for rheumatoid arthritis
L A Criswell1, K G Saag, K M Sems
1Division of Rheumatology, University of California, San Francisco, 521 Parnassus Avenue, C405, Box 0633, San Francisco, CA 94143-0633, USA. lac@itsa.ucsf.edu
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Low-dose corticosteroids significantly improve rheumatoid arthritis (RA) symptoms compared to placebo. Prednisone treatment showed comparable efficacy to aspirin and chloroquine for RA disease activity measures.
Area of Science:
- Rheumatology
- Pharmacology
- Clinical Trials
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Low-dose corticosteroids are used for RA management.
- Evidence for their moderate-term efficacy requires systematic review.
Purpose of the Study:
- To systematically review the moderate-term efficacy of low-dose corticosteroids in treating rheumatoid arthritis (RA).
Main Methods:
- Systematic literature search of MEDLINE and rheumatology journals (1966-1998).
- Inclusion of randomized or cross-over trials of at least 3 months duration.
- Quantitative assessment of outcomes like joint tenderness, swelling, grip strength, and ESR.
Main Results:
- Seven studies met inclusion criteria; many identified studies were of poor quality.
- Corticosteroids significantly outperformed placebo for joint tenderness, swelling, pain, and functional status.
- No significant differences were found for grip strength or ESR compared to placebo.
Conclusions:
- Limited data suggest moderate-term prednisone is superior to placebo for RA.
- Prednisone demonstrated comparable effectiveness to aspirin and chloroquine in improving RA disease activity measures.