Efficacy of GCs in patients with early arthritis
| Study | Trial | LoE | Population and controls | Intervention | Time point | Clinical outcomes | Radiographic progression (SHS change >0.5) | Risk of bias | |
|---|---|---|---|---|---|---|---|---|---|
| Verschueren et al16 | CareRA | 2c | 43 pts with low risk† ERA | PRED from 30 to 0 mg/day in 34 weeks | 16 weeks | Remission DAS28-CRP | 65.1%$ | NA | High‡ |
| 47 pts with low risk† ERA | No GC | 46.8% | |||||||
| De Jong et al17 | tREACH | 1b | 91 pts with ERA | Intramuscular: MP 120 or TRIAM 80 mg at inclusion | 1 year | Remission DAS | 61% | 21% | High§ |
| 93 pts with ERA | Oral: PRED from 15 to 0 mg/day in 10 weeks | 54% | 24% | ||||||
| Menon et al18 | 2c | 25 pts with ERA | TRIAM 40 mg in every SJ at baseline | 12 weeks | ACR20/50/70 | 100*/60**/36** | NA | High‡ | |
| 25 pts with ERA | No GC | 84/20/0 | |||||||
Intervention versus controls p values: $p=0.08; *p<0.05; **p<0.01.
†Low risk definition: (1) No erosion+rheumatoid factor (RF)/ACPA negative or (2) No erosion+RF and/or ACPA positive+DAS28-CRP≤3.2 or (3) Erosion+RF/ACPA negative+DAS28-CRP≤3.2.
‡Open design.
§Assessor single-blind trial.
ACPA, anticitrullinated protein antibody; ACR, American College of Rheumatology; CRP, C reactive protein; DAS28, Disease Activity Score 28 joints; ERA, early rheumatoid arthritis; GCs, glucocorticoids; LoE, level of evidence; MP, methylprednisolone; NA, not available; NS, not significant; PRED, prednisone; TRIAM, triamcinolone.