[Use of pulsed steroid therapy in active rheumatoid arthritis]

The authors implemented a prospective double blind, controlled study where they administered to a group of 34 patients with active rheumatoid arthritis either three pulses a 1000 mg methyl prednisolone in a small infusion or an infusion with placebo. They proved a very favourable effect--after five days a marked diminution of morning stiffness was recorded, as well as a diminution of pain during locomotion and rest and general improvement of the patient's condition. After two weeks the effect declines but even after 8 weeks the difference, as compared with the initial value, was still significant, while this was not the case after placebo. The sedimentation rate increased after the initial decline to the baseline level. A number of immunological indicators (decline of immunoglobulins, IgG rheumatoid factor, rise of C3 and C4 complement levels and rise of T lymphocytes) suggest an anti-inflammatory and immunosuppressive action persisting for several weeks although the mentioned results were not statistically significant (the majority at the very borderline of significance, probably significant in a larger number of patients). The authors confirm the reactive safety of this treatment, emphasize the necessity to investigate contraindications of treatment (diabetes mellitus) and the necessity to follow up patients in inpatient facilities.