Safety and efficacy associated with long-term low-dose glucocorticoids in rheumatoid arthritis: a systematic review and meta-analysis
Authors' conclusion
There is very low to moderate QoE for no harm with long-term low dose GCs in RA, except for an increased risk of infections in GC users.
Study context
- Population
- RA
- Participants
- 1,078 participants6 RCTs
- Comparison
- Low-dose glucocorticoids (GCs) vs placebo over at least 2 years
- Outcome
- AEs
Methodological detailsprotocolised, double-blind, placebo-controlled RCTs, random-effects meta-analyses, Cochrane RoB tool and GRADE
- Protocolised
- Double-blind, placebo-controlled RCTs
- Random-effects meta-analyses
- Cochrane RoB tool and GRADE
Pooled result
As reported in the abstract
≥2 years
No evidence of increased risk of adverse events (AEs) with low-dose GCs vs placebo: incidence rate ratio
1.08 (0.86, 1.34); P = 0.52 (95% CI)
Further pooled results
Disease activity (DAS28)
- Improvement in DAS28 with GCs
- −0.23; −0.43 to −0.03
- Moderate to high quality evidence
Function (HAQ)
- Improvement in HAQ with GCs
- −0.09; −0.18 to 0.00
- Moderate to high quality evidence
Larsen scores
- Improvement in Larsen scores with GCs
- −4.61; −7.52 to −1.69
- Moderate to high quality evidence
Other efficacy outcomes, incl. Sharp van der Heijde scores
- No evidence of benefits with GCs
Safety
| Outcome | RR (CI) | |
|---|---|---|
| InfectionsModerate QoE | 1.4 (1.19–1.65) | |
| 0.512Relative risk (log scale) |
Original publication
Safety and efficacy associated with long-term low-dose glucocorticoids in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford). Published 22 February 2023. doi:10.
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