Academic Journal
A two year randomised controlled trial of IM depot steroids in patients with established rheumatoid arthritis who have shown an incomplete response to disease modifying anti-rheumatic drugs
| العنوان: | A two year randomised controlled trial of IM depot steroids in patients with established rheumatoid arthritis who have shown an incomplete response to disease modifying anti-rheumatic drugs |
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| المؤلفون: | Choy, Ernest H, Kingsley, Gabrielle H, Khoshaba, Bernadette, Pipitone, Nicolo, Scott, David L |
| بيانات النشر: | BMJ Publishing Group Ltd |
| سنة النشر: | 2005 |
| المجموعة: | HighWire Press (Stanford University) |
| مصطلحات موضوعية: | Extended Report |
| الوصف: | Objectives: In rheumatoid arthritis, intra- muscular (IM) pulsed depomedrone expedites the immediate response to disease modifying anti-rheumatic drugs (DMARDs). Though IM depomedrone is also widely used to treat disease flares in DMARD-treated patients, its effect on radiological progression has not been assessed. We therefore undertook a 2-year prospective randomised controlled trial to evaluate the benefits of 120mg IM depomedrone versus placebo in established RA patients whose disease was inadequately controlled by existing DMARDs. Methods: Patients were assessed using the ILAR/WHO core data set, disease activity score (DAS28), X-rays of hands and feet scored by Larsen's method and bone densitometry. Results: 291 RA patients were screened, 166 were eligible and 91 consented and were randomised. Disease activity improved more rapidly in the steroid-treated patients compared to placebo but after 6 months no difference remained. There was also a small but significant reduction in erosive damage in the steroid group compared to placebo. There was a significant excess of adverse reactions in the steroid-treated group (55 versus 42), especially those traditionally related to steroids (15 versus 2) including vertebral fracture, diabetes and myocardial infarction. Hip bone density fell significantly in steroid-treated but not placebo patients. Conclusions: IM depomedrone gave a short-term benefit in disease activity and a small reduction in bone erosion at the cost of a significant increase in adverse events. Despite the initial benefit of IM depomedrone, when patients respond suboptimally to a DMARD, they should not be given long-term additional steroids but should be treated with alternative or additional DMARDs. |
| نوع الوثيقة: | text |
| وصف الملف: | text/html |
| اللغة: | English |
| Relation: | http://ard.bmj.com/cgi/content/short/ard.2004.030908v1; http://dx.doi.org/10.1136/ard.2004.030908 |
| DOI: | 10.1136/ard.2004.030908 |
| الاتاحة: | http://ard.bmj.com/cgi/content/short/ard.2004.030908v1 https://doi.org/10.1136/ard.2004.030908 |
| Rights: | Copyright (C) 2005, BMJ Publishing Group Ltd |
| رقم الانضمام: | edsbas.BFABBED7 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/ard.2004.030908 |
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