Tapering and discontinuation of oral glucocorticoids without deterioration of disease status in patients with rheumatoid arthritis under a stable treatment.

Abstract:

OBJECTIVE:To retrospectively evaluate whether oral glucocorticoid (GC) administration can be tapered or discontinued over a 2-year observation period in patients with rheumatoid arthritis (RA) undergoing a stable oral GC treatment, without deterioration in the disease status. METHODS:Methotrexate (MTX) and prednisolone (PSL) dosages were increased and decreased, respectively, to the maximum extent possible. Concomitant biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) were used as required. Changes in PSL and MTX use and disease status were evaluated at baseline (BL), year-1, and year-2. RESULTS:Thirty-six patients were enrolled (median age, 65.4 years; disease duration, 7.1 years). The proportion of patients using PSL decreased over 2 years (100%-13.9%, P <0.0001). While no change was observed in the proportion of patients using MTX, the average administered dose increased at year-1 (P = 0.06). Moreover, b/tsDMARDs were administered in nine patients (two in year-1, seven in year-2). The Clinical Disease Activity Index remission rate increased from 25.0% to 38.9%. Serious adverse events were identified in two patients. CONCLUSIONS:Oral GC administration was discontinued without deterioration in the rheumatoid arthritis disease control.

journal_name

Mod Rheumatol

journal_title

Modern rheumatology

authors

Hirata S,Kohno H,Watanabe H,Tokunaga T,Yoshida Y,Sugimoto T,Mokuda S,Oda K,Nojima T,Sugiyama E

doi

10.1080/14397595.2020.1864914

subject

Has Abstract

pub_date

2020-12-16 00:00:00

pages

1-15

eissn

1439-7595

issn

1439-7609

pub_type

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