Table 2

Efficacy of GCs in patients with early arthritis

StudyTrialLoEPopulation and controlsInterventionTime pointClinical outcomesRadiographic progression (SHS change >0.5)Risk of bias
Verschueren et al16CareRA2c43 pts with low risk† ERAPRED from 30 to 0 mg/day in 34 weeks16 weeksRemission DAS28-CRP65.1%$NAHigh‡
47 pts with low risk† ERANo GC46.8%
De Jong et al17tREACH1b91 pts with ERAIntramuscular: MP 120 or TRIAM 80 mg at inclusion 1 yearRemission DAS61%21%High§
93 pts with ERAOral: PRED from 15 to 0 mg/day in 10 weeks54%24%
Menon et al182c25 pts with ERATRIAM 40 mg in every SJ at baseline12 weeksACR20/50/70100*/60**/36**NAHigh‡
25 pts with ERANo GC84/20/0
  • 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.