The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients
Abstract Background The ACR/EULAR recommendations endorse the use of glucocorticoids (GCs) for rheumatoid arthritis (RA) patients’ flares and as a bridge to a DMARD. However, the recommendation of low dose short-term monotherapy with (GCs) remains open to the discretion of the clinician. The aim of...
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doaj-14409e795dfd48b7850bccf152abe78b2021-08-15T11:31:56ZengBMCAdvances in Rheumatology2523-31062021-08-016111610.1186/s42358-021-00205-4The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patientsJohn M. Stacy0Jacob R. Greenmyer1James R. Beal2Abe E. Sahmoun3Erdal Diri4University of North Dakota School of Medicine and Health SciencesUniversity of North Dakota School of Medicine and Health SciencesDepartment of Family and Community Medicine, University of North Dakota School of Medicine and Health SciencesDepartment of Internal Medicine, University of North Dakota School of Medicine and Health SciencesDivision of Rheumatology, Trinity Medical GroupAbstract Background The ACR/EULAR recommendations endorse the use of glucocorticoids (GCs) for rheumatoid arthritis (RA) patients’ flares and as a bridge to a DMARD. However, the recommendation of low dose short-term monotherapy with (GCs) remains open to the discretion of the clinician. The aim of this study was to assess whether a short-term use of low dose prednisone monotherapy was effective in inducing remission in newly diagnosed RA patients. Methods A retrospective analysis of patients newly diagnosed with RA at a Community Health Center in North Dakota was performed based on the ACR/EULAR RA classification criteria. Demographic and clinical data were abstracted from patients’ medical charts. Patients treated with (< 10 mg/day) of prednisone up to 6 months were included. Response to prednisone was analyzed according to pre- and post-treatment DAS28-ESR score and EULAR response criteria. Results Data on 201 patients were analyzed. The mean prednisone dose was 8 mg/day (range: 5–10; SD = 1.2) and the mean treatment duration was 42.2 days (12–177; 16.9). Disease severity significantly improved from baseline to follow-up for: tender joint count (8.6 ± 4.8 vs. 1.5 ± 3.3; P < 0.001), swollen joint count (6.2 ± 5.0 vs. 1.4 ± 3.0; P < 0.001), and visual analog pain score (4.8 ± 2.6 vs. 2.1 ± 2.5; P < 0.001). DAS28-ESR disease severity significantly improved from baseline to follow-up: (5.1 ± 1.2 vs. 2.7 ± 1.3; P < 0.001). Per EULAR response criteria, 69.7% of patients showed good response to treatment and 20.4% showed moderate response. 54.2% of patients reached remission. Conclusion Short-term use of low dose prednisone monotherapy induced disease remission and improved clinical severity of RA in the majority of newly diagnosed patients.https://doi.org/10.1186/s42358-021-00205-4Rheumatoid arthritisPrednisoneEfficacyLow doseShort-termRemission |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
John M. Stacy Jacob R. Greenmyer James R. Beal Abe E. Sahmoun Erdal Diri |
spellingShingle |
John M. Stacy Jacob R. Greenmyer James R. Beal Abe E. Sahmoun Erdal Diri The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients Advances in Rheumatology Rheumatoid arthritis Prednisone Efficacy Low dose Short-term Remission |
author_facet |
John M. Stacy Jacob R. Greenmyer James R. Beal Abe E. Sahmoun Erdal Diri |
author_sort |
John M. Stacy |
title |
The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients |
title_short |
The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients |
title_full |
The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients |
title_fullStr |
The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients |
title_full_unstemmed |
The efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients |
title_sort |
efficacy of low dose short-term prednisone therapy for remission induction in newly diagnosed rheumatoid arthritis patients |
publisher |
BMC |
series |
Advances in Rheumatology |
issn |
2523-3106 |
publishDate |
2021-08-01 |
description |
Abstract Background The ACR/EULAR recommendations endorse the use of glucocorticoids (GCs) for rheumatoid arthritis (RA) patients’ flares and as a bridge to a DMARD. However, the recommendation of low dose short-term monotherapy with (GCs) remains open to the discretion of the clinician. The aim of this study was to assess whether a short-term use of low dose prednisone monotherapy was effective in inducing remission in newly diagnosed RA patients. Methods A retrospective analysis of patients newly diagnosed with RA at a Community Health Center in North Dakota was performed based on the ACR/EULAR RA classification criteria. Demographic and clinical data were abstracted from patients’ medical charts. Patients treated with (< 10 mg/day) of prednisone up to 6 months were included. Response to prednisone was analyzed according to pre- and post-treatment DAS28-ESR score and EULAR response criteria. Results Data on 201 patients were analyzed. The mean prednisone dose was 8 mg/day (range: 5–10; SD = 1.2) and the mean treatment duration was 42.2 days (12–177; 16.9). Disease severity significantly improved from baseline to follow-up for: tender joint count (8.6 ± 4.8 vs. 1.5 ± 3.3; P < 0.001), swollen joint count (6.2 ± 5.0 vs. 1.4 ± 3.0; P < 0.001), and visual analog pain score (4.8 ± 2.6 vs. 2.1 ± 2.5; P < 0.001). DAS28-ESR disease severity significantly improved from baseline to follow-up: (5.1 ± 1.2 vs. 2.7 ± 1.3; P < 0.001). Per EULAR response criteria, 69.7% of patients showed good response to treatment and 20.4% showed moderate response. 54.2% of patients reached remission. Conclusion Short-term use of low dose prednisone monotherapy induced disease remission and improved clinical severity of RA in the majority of newly diagnosed patients. |
topic |
Rheumatoid arthritis Prednisone Efficacy Low dose Short-term Remission |
url |
https://doi.org/10.1186/s42358-021-00205-4 |
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