Low dose prednisone therapy in rheumatoid arthritis: a double blind study

Prednisone, 5 mg taken each morning, was added to other drugs in 18 patients with rheumatoid arthritis. Sixteen patients were given a placebo in this double blind study. After 24 weeks, all patients were given the placebo. Slight functional improvement was noted in the prednisone group during the 24-week period, but deterioration after switching to placebo was sustained for at least 8 weeks. Progression of hand erosions occurred in 1 prednisone-treated patient, and in 4 controls. An asymptomatic vertebral spine compression fracture developed in 2 patients given prednisone; this was the only toxicity noted possibly due to this therapy. Minimal dose prednisone may be useful as "bridge" therapy between nonsteroidal antiinflammatory therapy and use of disease-modifying drugs.