( s of glucocorticoid pills along with so...)Low-Dose Steroids Reduce Joint Damage From Rheumatoid Arthritis,Health

s of glucocorticoid pills along with so-called disease-modifying drugs for one to two years. Periodic X-rays revealed the extent of joint erosion and other signs of damage.

All studies except one showed reduced progression of joint damage in patients taking glucocorticoids. When reviewers used statistical methods to focus on only the highest-quality data, the benefits remained statistically significant.

“Even in the most conservative estimate, the evidence that glucocorticoids given in addition to standard therapy can substantially reduce the rate of erosion progression in rheumatoid arthritis is convincing,” they say.

The authors say, however, that minimization of joint damage seen on X-rays may not equate to noticeable improvements for patients: “It does not necessarily follow that patients will gain long-term functional benefit.” However, two related studies, including one by Kirwan, suggest “an important link” between the two.

Because of the known health risks associated with intensive steroid use, concern persists regarding long-term use at any level. The authors cite a 2006 systematic review covering the adverse effects of low-dose glucocorticoids, which concluded that “few of the commonly held beliefs about their incidence, prevalence and impact are supported by clear scientific evidence.”

Moreover, safety data from recent randomized controlled clinical trials of low-dose steroids for RA suggest that negative side effects are “modest” and similar to those of sham treatments, say Kirwan and colleagues. Additionally, the most immediate concern — reduced bone mineral density — can now be readily treated.

Nevertheless, potential adverse reactions to glucocorticoid therapy merit further research, say the authors, as does usefulness of steroid treatment for patients who have had rheumatoid arthritis for 3 years or more.

Zashin urges patients recently diagnosed with rheumatoid art
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