Clinical Edge Journal Scan

No effect of initial glucocorticoid bridging on glucocorticoid use over time in RA


 

Key clinical point: In patients with newly diagnosed rheumatoid arthritis (RA), initial glucocorticoid bridging (GB) led to more rapid clinical improvements than non-bridging, without any apparent risk for increased glucocorticoid use after the intended bridging period.

Major finding: The risk of using glucocorticoids at 12 months was higher in the GB vs non-bridging group, but this risk reduced over time and was not significantly different at 18 and 24 months. The cumulative doses did not differ significantly between groups after the planned bridging schedule. Patients in the GB group showed more rapid improvements in the mean Disease Activity Score of 28 Joints during the first 6 months (P < .001).

Study details: This individual patient data meta-analysis combined data from three randomized clinical trials and included 625 patients with newly diagnosed RA who received conventional synthetic disease-modifying antirheumatic drugs with (n = 252) or without (n = 373) initial GB.

Disclosures: This study did not declare any specific funding source. Some authors declared receiving consultancy or speaker honoraria, fees, or grants from or providing expert advice or testimony for or serving as chair for various sources.

Source: van Ouwerkerk L et al. Initial glucocorticoid bridging in rheumatoid arthritis: Does it affect glucocorticoid use over time? Ann Rheum Dis. 2023 (Aug 22). doi: 10.1136/ard-2023-224270

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