Clinical Edge Journal Scan

RA: Systemic glucocorticoids most beneficial for pain reduction shortly after initiation


 

Key clinical point: Systemic glucocorticoids (GCs) were effective at reducing pain in patients with active rheumatoid arthritis (RA), with the effect being greatest within 3 months of initiation, whereas it appeared to be less effective beyond 6 months.

Major finding: Treatment with systemic GCs significantly decreased spontaneous pain (standardized mean differences [MD], −0.67; 95% confidence interval [CI], −0.84 to −0.50), with the effect being greatest at 3 months or lesser (MD, −14.55 mm; 95% CI, −20.40 to −8.69) and appeared to be less effective at more than 3 to 6 months (MD, −7.82 mm; 95% CI, −12.27 to -3.38) and beyond 6 months (MD, −6.52 mm; 95% CI, −13.28 to 0.24).

Study details: Findings are from a systematic review and meta-analysis of 33 randomized controlled trials including 2,658 patients with RA.

Disclosures: The study received no specific funding. D McWilliams, DA Walsh, and NG Shanker reported receiving grant support and consultancy fees from various sources like Pfizer Ltd., Eli Lilly, UCB, AbbVie, GSK, and Cambridge Nutraceuticals.

Source: McWilliams DF et al. Rheumatology (Oxford). 2021 Jul 2. doi: 10.1093/rheumatology/keab503 .

Recommended Reading

Clinical Edge Commentary: RA July 2021
MDedge Rheumatology
HR-pQCT scanning has comparable diagnostic precision to conventional radiography for classifying erosive RA
MDedge Rheumatology
Clusterin could serve as a potential predictive biomarker for disease activity and treatment response in early RA
MDedge Rheumatology
Baricitinib shows long-term promise in treatment-refractory RA
MDedge Rheumatology
Risk for ischemic stroke higher in seropositive RA patients
MDedge Rheumatology
Vertebral fractures still a risk with low-dose oral glucocorticoids for RA
MDedge Rheumatology
COVID-19 vaccine hesitancy still weighs heavy for some rheumatic disease patients
MDedge Rheumatology
Commentary: RA August 2021
MDedge Rheumatology
RA: No significant change in efficacy and safety after adalimumab to CT-P17 switch
MDedge Rheumatology
Bazedoxifene effectively prevents glucocorticoid-induced bone loss in RA
MDedge Rheumatology