Comparison of two strategies of glucocorticoid withdrawal in patients with rheumatoid arthritis in low disease activity (STAR): a randomised, placebo- controlled, double-blind trial
Authors' conclusion
A hydrocortisone replacement strategy was not superior to a prednisone tapering strategy for achieving glucocorticoid discontinuation success in patients with RA in LDA.
Study context
- Population
- Patients with rheumatoid arthritis (RA) on a stable GC dose of 5 mg/day for ≥3 months and in low disease activity (LDA) for ≥3 monthsmean age 62.4 years, 70.6% females
- Participants
- 102 patients
- Comparison
- Hydrocortisone replacement vs prednisone tapering
- Hydrocortisone replacementn = 53
- Prednisone taperingn = 49reference
- Primary endpoint
- Percentage of patients achieving GC discontinuation
- Follow-up
- 12 months
Methodological detailsdouble-blind, double-placebo
- Double-blind
- Double-placebo
Primary result
As reported in the abstract
GC discontinuation
P = 0.4
Secondary outcomes
Secondary outcomes (flares, additional GC use, disease activity, patient-reported outcomes, adrenocorticotropic hormone (ACTH) stimulation tests)
- No difference between groups
Safety
Acute adrenal insufficiency
- No cases observed
Abnormal ACTH stimulation test · 12 months
- Patients with abnormal test, no differences between arms
- 17
Original publication
Comparison of two strategies of glucocorticoid withdrawal in patients with rheumatoid arthritis in low disease activity (STAR): a randomised, placebo- controlled, double-blind trial. Ann Rheum Dis. Published 2 January 2025. doi:10.
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