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Therapeutics
Prednisolone plus a disease modifying antirheumatic drug improved outcomes in early rheumatoid arthritis

https://doi.org/10.1136/ebm.11.3.79

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    Svensson B, Boonen A, Albertsson K, et al. 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;52:3360–70.
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 Q In patients with early rheumatoid arthritis (RA), does adding low dose prednisolone to the first use of a disease modifying antirheumatic drug (DMARD) improve outcomes?

    Clinical impact ratings IM/Ambulatory care ★★★★★★☆ Rheumatology ★★★★★☆☆

    METHODS

    Embedded ImageDesign

    randomised controlled trial.

    Embedded ImageAllocation

    concealed.*

    Embedded ImageBlinding

    blinded (outcome assessors).*

    Embedded ImageFollow up period

    2 years.

    Embedded ImageSetting

    6 centres in southern Sweden.

    Embedded ImagePatients

    259 patients 18–80 years of age (mean age 55 y, 64% women) who were starting treatment with a first DMARD for active RA of ⩽1 year’s duration. Patients with previous DMARD or glucocorticoid treatment, low bone mineral density (BMD), or a history of fragility fracture were excluded.

    Embedded ImageInterventions

    prednisolone, 7.5 mg daily for 2 years (n = 124), or no prednisolone (n = 135). The choice of DMARD (mainly methotrexate or sulfasalazine) was at the attending physician’s discretion. All patients also received calcium, 1000 mg daily.

    Embedded ImageOutcomes

    change in joint damage in the hands and …

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    Footnotes

    • ↵* See glossary

    • For correspondence: Dr B Svensson, University of Lund, Lund, Sweden. bjoern.svensson{at}swipnet.se

    • Sources of funding: Swedish Rheumatism Association; 80-Year Foundation of King Gustaf V; Ugglas Foundation; Börje Dahlins Foundation; Gorthon Foundation in Helinsingborg; Stiftelsen för Rörelsehindrade I Skåne.

    Linked Articles

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      BMJ Publishing Group Ltd
      BMJ Evidence-Based Medicine 2006; 11 95a-95a Published Online First: 30 May 2006. doi: 10.1136/ebm.11.3.95a