Low dose prednisolone therapy (LDPT) retards radiographically detectable destruction in early rheumatoid arthritis

摘要: Objective:To test if continuous LDPT decreases radiographically detectable joint destruction in early RA. Methods: Patients with active RA (< 2 years from symptom onset) were treated prednisolone 5 mg daily or placebo for a double blind, randomized, multi-center study. At the same time all patients DMARD treatment either gold sodium thiomalate (GSTM) methotrexate (MTX) was started; case of side effects inefficacy medication could be switched to other DMARD. Radiographs hands and forefeet taken at baseline after 6, 12 24 months. All radiographs evaluated by one observer (S. W.) knowing sequence film but unaware patient identity using Ratingen score van der Heijde's modification Sharp's method. Results: 196 included; 76 completed study per protocol. Of these 34 prednisolone, 42 placebo, 48 initially GSTM, 28 MTX. 17 GSTM MTX, 1 MTX GSTM. The mean values radiographic scores both groups are given table. During first year, especially during 6 months, progression within group significantly lower than group: Sharp erosion increased 0.4% maximum possible second months group, while there an increase 1.8% month 0.8% year (−0.1% 0.2% group). After total had 2.6% 1.1% group. results completers confirmed intention-to-treat analysis (80 86 Conclusion: Continuous low dose over administered addition conventional treat also show that is sharp decrease 6–12 as result treatment. nearly no this data “completers” “intention treat” population.