Low-Dose Steroids to Prevent RA Disease Progression?

Corticosteroids clearly can relieve symptoms of rheumatoid arthritis (RA). However, their use has been limited by side effects and by concern that steroids may not prevent joint destruction. Could low-dose steroids cause fewer side effects and have disease-modifying antirheumatic properties? In a randomized, double-blind study, investigators in the Netherlands compared prednisone (10 mg each morning) with placebo in 81 patients who had had untreated RA for less than 1 year. After 6 months, physicians could add sulfasalazine (2 g daily).

At 12 and 24 months, prednisone recipients had significantly less joint tenderness and radiologic damage and greater grip strength than did placebo recipients. There were no differences in functional disabili…