- See:
-
Rheumatoid Arthritis
-
Steroids:
- Discussion:
-
corticosteroids may occassionally be used to alleviate intractable joint inflammation or vasculitis in RA;
- however, there is a risk of iatrogenic Cushing's syndrome;
- intraarticular instillation of steroids is useful in management of disease that is worst in a single joint;
- repeated injections increase the risk of articular cartilage damage from catabolic effects of local steroids;
- Dosage:
- daily doses of > 5-7.5 mg of
prednisone or its equivalent should be avoided
because of
side effects produced by glucocorticoids, especially diminishing of bone mineral content;
- low dose (5 to 7.5 mg per day given as a single dose) may benefit certain patients with little risk of morbidity;
- Musculoskeletal Effects of Chronic Steroid Usage:
Pulse steroid therapy in rheumatoid arthritis: can equivalent doses of oral prednisolone give similar clinical results to intravenous methylprednisolone
Meta analysis of short term low dose prednisolone versus placebo and non steroidal anti-inflammatory drugs in RA.
PC Gotasche et al.
BMJ. Mar. 1998. Vol 316. p 811-818.
