Steroid Use in RA More Common than 20 Years Ago
Written by Editor   
Monday, May 19, 2014 08:07 AM

More patients with rheumatoid arthritis today are initiating treatment with glucocorticoids (GCs) early in the course of disease than was the case 20 years ago, a retrospective study found.

During the first year of disease, 68% of patients diagnosed with rheumatoid arthritis between 1995 and 2007 started GCs compared with 36% of those diagnosed between 1980 and 1994.  These findings may reflect shifting patterns of rheumatoid arthritis treatment, away from a "step-up" approach toward an early, aggressive, treat-to-target approach.  "More aggressive use of glucocorticoids early in rheumatoid arthritis may be representative of a change in goals of treatment from merely controlling disease activity to inducing a state of remission," researchers commented.

Glucocorticoids have been an indispensable component of rheumatoid arthritis treatment for decades as cost-effective anti-inflammatory drugs, but their potentially severe toxicities limit their use, and "there remains significant controversy among clinicians with respect to their efficacy, safety, optimal dose, and duration of therapy,"

"Certainly they have many side effects, and it is the goal of most physicians and patients to use them sparingly, at the lowest possible dose, and ultimately to be able to discontinue their use altogether in individual patients over time," explained the chair of the department of rheumatology at the Mayo Clinic.