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The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients

Authors
  • Stacy, John M.1
  • Greenmyer, Jacob R.1
  • Beal, James R.1
  • Sahmoun, Abe E.2
  • Diri, Erdal3
  • 1 University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA , Grand Forks (United States)
  • 2 University of North Dakota School of Medicine and Health Sciences, Forks, ND, USA , Forks (United States)
  • 3 Trinity Medical Group, Minot, ND, USA , Minot (United States)
Type
Published Article
Journal
Advances in Rheumatology
Publisher
BioMed Central
Publication Date
Aug 09, 2021
Volume
61
Issue
1
Identifiers
DOI: 10.1186/s42358-021-00205-4
Source
Springer Nature
Keywords
Disciplines
  • Research
License
Green

Abstract

BackgroundThe ACR/EULAR recommendations endorse the use of glucocorticoids (GCs) for rheumatoid arthritis (RA) patients’ flares and as a bridge to a DMARD. However, the recommendation of low dose short-term monotherapy with (GCs) remains open to the discretion of the clinician. The aim of this study was to assess whether a short-term use of low dose prednisone monotherapy was effective in inducing remission in newly diagnosed RA patients.MethodsA retrospective analysis of patients newly diagnosed with RA at a Community Health Center in North Dakota was performed based on the ACR/EULAR RA classification criteria. Demographic and clinical data were abstracted from patients’ medical charts. Patients treated with (< 10 mg/day) of prednisone up to 6 months were included. Response to prednisone was analyzed according to pre- and post-treatment DAS28-ESR score and EULAR response criteria.ResultsData on 201 patients were analyzed. The mean prednisone dose was 8 mg/day (range: 5–10; SD = 1.2) and the mean treatment duration was 42.2 days (12–177; 16.9). Disease severity significantly improved from baseline to follow-up for: tender joint count (8.6 ± 4.8 vs. 1.5 ± 3.3; P < 0.001), swollen joint count (6.2 ± 5.0 vs. 1.4 ± 3.0; P < 0.001), and visual analog pain score (4.8 ± 2.6 vs. 2.1 ± 2.5; P < 0.001). DAS28-ESR disease severity significantly improved from baseline to follow-up: (5.1 ± 1.2 vs. 2.7 ± 1.3; P < 0.001). Per EULAR response criteria, 69.7% of patients showed good response to treatment and 20.4% showed moderate response. 54.2% of patients reached remission.ConclusionShort-term use of low dose prednisone monotherapy induced disease remission and improved clinical severity of RA in the majority of newly diagnosed patients.

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