Tapering and discontinuation of oral glucocorticoids without deterioration of disease status in patients with rheumatoid arthritis under a stable treatment. Issue 4 (4th July 2021)

• Record Type: Journal Article
• Authors: Hirata, Shintaro; Kohno, Hiroki; Watanabe, Hirofumi; Tokunaga, Tadahiro; Yoshida, Yusuke; Sugimoto, Tomohiro; Mokuda, Sho; Oda, Keisuke; Nojima, Takaki; Sugiyama, Eiji
• Is Part Of: Modern rheumatology. Volume 31:Issue 4(2021)
• Page Start: 803
• Page End: 808
• Publication Date: 2021-07-04
• Subjects: Disease modifying anti-rheumatic drugs (DMARDs); glucocorticoids (GCs) -- methotrexate (MTX) -- rheumatoid arthritis (RA) -- tapering; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1080/14397595.2020.1864914
• Languages: English
• ISSNs: 1439-7595

Abstract

Abstract: Objective: To retrospectively evaluate whether oral glucocorticoid (GC) administration can be tapered or discontinued over a 2-year observation period in patients with rheumatoid arthritis (RA) undergoing a stable oral GC treatment, without deterioration in the disease status. Methods: Methotrexate (MTX) and prednisolone (PSL) dosages were increased and decreased, respectively, to the maximum extent possible. Concomitant biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) were used as required. Changes in PSL and MTX use and disease status were evaluated at baseline (BL), year-1, and year-2. Results: Thirty-six patients were enrolled (median age, 65.4 years; disease duration, 7.1 years). The proportion of patients using PSL decreased over 2 years (100–13.9%, p < .0001). While no change was observed in the proportion of patients using MTX, the average administered dose increased at year-1 ( p = .06). Moreover, b/tsDMARDs were administered in nine patients (two in year-1, seven in year-2). The Clinical Disease Activity Index remission rate increased from 25.0% to 38.9%. Serious adverse events were identified in two patients. Conclusions: Oral GC administration was discontinued without deterioration in the rheumatoid arthritis disease control.