Low-Dose Steroids Reduce Joint Damage Associated With Rheumatoid Arthritis

Thursday January 25, 2007

Low-dose steroids (i.e. glucocorticoids such as prednisone) can inhibit joint damage when prescribed early in the course of rheumatoid arthritis. The evidence appears in The Cochrane Library, a publication of The Cochrane Collaboration, and is based on a review of 15 studies which involved 1,414 patients. Patients were treated with low doses of glucocorticoid pills and DMARDs (disease-modifying anti-rheumatic drugs) for one to two years.

X-rays were periodically used to assess the progression of joint erosion and other signs of joint damage. Of the studies which were reviewed, all but one concluded that glucocorticoids given along with standard arthritis treatments significantly reduced the rate of joint erosion in rheumatoid arthritis patients. It did not necessarily correlate with long-term improvement in function however.

Concern over side effects associated with steroids has long been an issue for patients treated with the drugs or considering their use. High doses of steroids have been associated with osteoporosis, heart disease, and many other complications. Safety concerns have caused rheumatologists to use the lowest dose of steroids for the shortest amount of time possible in most cases. Researchers suggest that potential adverse effects associated with steroid therapy for rheumatoid arthritis requires further study, as does the usefulness of steroid treatment for rheumatoid arthritis patients who have had the disease for 3 years or longer. Commenting on the latest review of steroid treatment, rheumatologist Scott J. Zashin, M.D., said "Now, we have to give steroids a little more respect."

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