Exclusive: ACR Convergence 2024| Focus Rheums

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Is Predisone 3 mg/day an Appropriate Dose for Patients with Rheumatoid Arthritis?

Theodore Pincus, MD  |  Issue: April 2013  |  

Dr. Pincus is clinical professor of medicine in the division of rheumatology at New York University School of Medicine and NYU Hospital for Joint Diseases in New York City.

References

  1. van der Goes MC, Jacobs JW, Boers M, et al. Monitoring adverse events of low-dose glucocorticoid therapy: EULAR recommendations for clinical trials and daily practice. Ann Rheum Dis. 2010; 69:1913-1919.
  2. Sokka T, Kautiainen H, Toloza S, et al. QUEST-RA: Quantitative clinical assessment of patients with rheumatoid arthritis seen in standard rheumatology care in 15 countries. Ann Rheum Dis. 2007;66:1491-1496.
  3. Harris ED, Jr., Emkey RD, Nichols JE, Newberg A. Low dose prednisone therapy in rheumatoid arthritis: A double blind study. J Rheumatol. 1983; 10:713-721.
  4. Scott DL, Grindulis KA, Struthers GR, Coulton BL, Popert AJ, Bacon PA. Progression of radiological changes in rheumatoid arthritis. Ann Rheum Dis. 1984;43:8-17.
  5. Pincus T, Callahan LF, Sale WG, Brooks AL, Payne LE, Vaughn WK. Severe functional declines, work disability, and increased mortality in seventy-five rheumatoid arthritis patients studied over nine years. Arthritis Rheum. 1984;27:864-872.
  6. de Andrade JR, McCormick JN, Hill AGS. Small doses of prednisolone in the management of rheumatoid arthritis. Ann Rheum Dis. 1964;23:158-162.
  7. Kirwan JR. The effects of glucocorticoids on joint destruction in rheumatoid arthritis. N Engl J Med. 1995;333:142-146.
  8. Boers M, Verhoeven AC, Markusse HM, et al. Randomised comparison of combined step-down prednisolone, methotrexate and sulphasalazine with sulphasalazine alone in early rheumatoid arthritis. Lancet. 1997;350:309-318.
  9. van Everdingen AA, Jacobs JWG, van Reesema DRS, Bijlsma JWJ. Low-dose prednisone therapy for patients with early active rheumatoid arthritis: Clinical efficacy, disease-modifying properties, and side effects. Ann Intern Med. 2002;136:1-12.
  10. Svensson B, Boonen A, Albertsson K, van der Heijde D, Keller C, Hafstrom I. Low-dose prednisolone in addition to the initial disease-modifying antirheumatic drug in patients with early active rheumatoid arthritis reduces joint destruction and increases the remission rate: A two-year randomized trial. Arthritis Rheum. 2005;52:3360-3370.
  11. Wassenberg S, Rau R, Steinfeld P, Zeidler H. Very low-dose prednisolone in early rheumatoid arthritis retards radiographic progression over two years: A multicenter, double-blind, placebo-controlled trial. Arthritis Rheum. 2005;52:3371-3380.
  12. Malysheva OA, Wahle M, Wagner U, et al. Low-dose prednisolone in rheumatoid arthritis: Adverse effects of various disease modifying antirheumatic drugs. J Rheumatol. 2008;35:979-985.
  13. Pincus T, Swearingen CJ, Luta G, Sokka T. Efficacy of prednisone 1-4 mg/day in patients with rheumatoid arthritis: A randomised, double-blind, placebo controlled withdrawal clinical trial. Ann Rheum Dis. 2009;68:1715-1720.
  14. Todoerti M, Scire CA, Boffini N, Bugatti S, Montecucco C, Caporali R. Early disease control by low-dose prednisone comedication may affect the quality of remission in patients with early rheumatoid arthritis. Ann N Y Acad Sci. 2010;1193:139-145.
  15. Buttgereit F, Mehta D, Kirwan J, Szechinski J, Boers M, Alten RE et al. Low-dose prednisone chronotherapy for rheumatoid arthritis: A randomised clinical trial (CAPRA-2). Ann Rheum Dis. 2013.72:204-210.
  16. Bakker MF, Jacobs JW, Welsing PM, et al. Low-dose prednisone inclusion in a methotrexate-based, tight control strategy for early rheumatoid arthritis: A randomized trial. Ann Intern Med. 2012;156:329-339.
  17. Saag KG, Criswell LA, Sems KM, Nettleman MD, Kolluri S. Low-dose corticosteroids in rheumatoid arthritis. A meta-analysis of their moderate-term effectiveness. Arthritis Rheum. 1996;39:1818-1825.
  18. Gotzsche PC, Johansen HK. Meta-analysis of short-term low dose prednisolone versus placebo and non-steroidal anti-inflammatory drugs in rheumatoid arthritis. BMJ. 1998;316:811-818.
  19. Saag KG, Koehnke R, Caldwell JR, et al. Low dose long-term corticosteroid therapy in rheumatoid arthritis: An analysis of serious adverse events. Am J Med. 1994;96:115-123.
  20. Wei L, MacDonald TM, Walker BR. Taking glucocorticoids by prescription is associated with subsequent cardiovascular disease. Ann Intern Med. 2004;141:764-770.
  21. Laan RF, van Riel PL, van de Putte LB, van Erning LJ, van’t Hof MA, Lemmens JA. Low-dose prednisone induces rapid reversible axial bone loss in patients with rheumatoid arthritis. A randomized, controlled study. Ann Intern Med. 1993;119:963-968.
  22. Pincus T, Brooks RH, Callahan LF. Prediction of long-term mortality in patients with rheumatoid arthritis according to simple questionnaire and joint count measures. Ann Intern Med. 1994;120:26-34.
  23. Sokka T, Pincus T. Ascendancy of weekly low-dose methotrexate in usual care of rheumatoid arthritis from 1980 to 2004 at two sites in Finland and the United States. Rheumatology (Oxford). 2008;47:1543-1547.
  24. Pincus T, Castrejon I, Sokka T. Long-term prednisone in doses of less than 5 mg/day for treatment of rheumatoid arthritis: Personal experience over 25 years. Clin Exp Rheumatol. 2011; 29(5 Suppl 68):S130-S138.
  25. Pincus T, Sokka T, Castrejón I, Cutolo M. Decline of mean initial prednisone dose from 10.3 to 3.6 mg/day to treat rheumatoid arthritis between 1980 and 2004 in one clinical setting, with long-term effectiveness of doses less than 5 mg/day. Arthritis Care Res. 2012; Nov 30. [Epub ahead of print]
  26. Pincus T, Swearingen CJ, Bergman MJ, et al. RAPID3 on an MDHAQ is correlated significantly with activity levels of DAS28 and CDAI, but scored in 5 versus more than 90 seconds. Arthritis Care Res. 2010; 62:181-189.
  27. Pincus T, Yazici Y, Sokka T. Are excellent systematic reviews of clinical trials useful for patient care? Nat Clin Pract Rheumatol. 2008;4:294-295.
  28. Moses LE. The series of consecutive cases as a device for assessing outcomes of intervention. N Engl J Med. 1984;311:705-710.
  29. Wolfe F, Hawley DJ. Remission in rheumatoid arthritis. J Rheumatol. 1985;12:245-252.
  30. Pincus T, Sokka T, Kautiainen H. Patients seen for standard rheumatoid arthritis care have significantly better articular, radiographic, laboratory, and functional status in 2000 than in 1985. Arthritis Rheum. 2005;52:1009-1019.
  31. LaRochelle GE, Jr., LaRochelle AG, Ratner RE, Borenstein DG. Recovery of the hypothalamic-pituitary-adrenal (HPA) axis in patients with rheumatic diseases receiving low-dose prednisone. Am J Med. 1993; 95:258-264.
  32. Caplan L, Wolfe F, Russell AS, Michaud K. Corticosteroid use in rheumatoid arthritis: Prevalence, predictors, correlates, and outcomes. J Rheumatol. 2007;34:696-705.

 

ADVERTISEMENT
SCROLL TO CONTINUE

Related Articles