Low dose corticosteroids in early rheumatoid arthritis. Can these drugs slow disease progression?

The role of corticosteroids in treating rheumatoid arthritis is controversial, but recourse to the available evidence of efficacy should guide patient management decisions. Earlier evidence suggested that symptomatic control could be improved for periods of 6 to 12 months, but not longer, without increasing doses to unacceptably high levels. The effect of corticosteroids on joint destruction has been unclear. Recent findings from a controlled clinical trial show that prednisolone 7.5 mg/day can significantly retard the rate of erosive progression in patients with relatively early disease (< 2 years' duration). These results have implications for both disease management and our understanding of the pathogenesis of joint destruction in rheumatoid arthritis.