A comparison of short-term efficacy and toxicity of 2 glucocorticoid bridging strategies in 2 clinical trials in early rheumatoid and undifferentiated arthritis
Main finding · DASResult — go to the resultDifference 0.62 95 % CI 0.43–0.80Authors' conclusion
In patients with early RA or UA, a study with higher dosed glucocorticoids as part of initial treatment was associated with significantly better early clinical outcomes compared to a study with lower dosed glucocorticoids, and fewer early side effects.
Study context
- Population
- Patients with early RA or undifferentiated arthritis
- Comparison
- Initial MTX with higher-dose glucocorticoid (GC) bridging vs lower-dose GC bridging
- Outcome
- DAS and HAQ, rates of DAS-remission (DAS<1.6) and low disease activity (DAS≤2.4)
- Follow-up
- First visit after 3 to 4 months
Methodological detailscross-trial comparison, multiple imputation, linear and logistic regression adjusted for baseline DAS/HAQ, age, gender, symptom duration, ACPA positivity, BMI and damage, More patients in the lower-dose GC-study fulfilled the 2010 criteria for RA
- Cross-trial comparison
- Multiple imputation
- Linear and logistic regression adjusted for baseline DAS/HAQ, age, gender, symptom duration, ACPA positivity, BMI and damage
- More patients in the lower-dose GC-study fulfilled the 2010 criteria for RA
Main finding
DAS · first follow-up visit
Difference
0.62
95 % CI 0.43–0.80
Lower-dose GCvs Higher-dose GC
difference 0.62 (95 % CI 0.43–0.80)
As reported in the abstract
Further findings
| Outcome | Difference (95 % CI) | |
|---|---|---|
| HAQ · first follow-up visitAdjusted for confounders; significantly higher | 0.28 (0.17–0.39) | |
| −0.200.20.4Difference (linear scale) |
DAS-remission (DAS<1.6) · first follow-up visit · less often in lower-dose GC
Low disease activity (DAS≤2.4) · first follow-up visit · less often in lower-dose GC
Safety
- Fewer adverse events reported in the higher-dose GC-study
Original publication
A comparison of short-term efficacy and toxicity of 2 glucocorticoid bridging strategies in 2 clinical trials in early rheumatoid and undifferentiated arthritis. Semin Arthritis Rheum. Published 3 May 2025. doi:10.
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