The origins, results and consequences of the 1995 Arthritis Research Campaign Low-Dose Glucocorticoid Study

The discovery and subsequent therapeutic use of glucocorticoids, which took 30 years, was stimulated by clinical observation and achieved by persistent investigation. Early reports of the potential of glucocorticoids to modify the underlying course of rheumatoid arthritis (RA) were overshadowed by pharmaceutical innovations with symptom relieving non-steroidal anti-inflammatory drugs (NSAIDs), and it was not until 1995 that clear-cut evidence of a powerful glucocorticoid disease-modifying action was published as the Arthritis Research Campaign Low-dose Glucocorticoid Study. This review reports how the study came to be designed and implemented, adds some additional information from the study not previously published, and considers the subsequent impact of the 1995 paper. Eighty years after Hench and colleagues made their first suggestion of benefit the UK National Health Service suggested all patients newly diagnosed with RA should have early access to glucocorticoid treatment.