New role for an old friend: prednisone is a disease-modifying agent in early rheumatoid arthritis

There has been a renewed interest in the use of low doses of prednisone in the treatment of early rheumatoid arthritis. This is because it has been conclusively shown that low doses of prednisone retard bone damage, and physicians use prednisone because it helps control tender and swollen joints. Two studies appeared in 2002, one by van Everdingen et al. and one by Landewe et al. demonstrating the reduction of bone damage in early RA with the use of prednisone. Van Everdingen used 10 mg/day of prednisone and Landewe used an initial high dose of 60 mg/day of prednisone for a week, tapering off by 6 months. The bone sparing effect was still evident at 5 years. Low doses of prednisone are well tolerated, with documented side effects including weight gain, ecchymosis, and osteopenia.