Treatment with methotrexate plus oral prednisolone versus triple therapy (methotrexate/sulfasalazine/hydroxychloroquine) plus intra-articular glucocorticoids in early rheumatoid arthritis: a prespecified nonrandomised subgroup analysis of clinical and radiographic data at 48 weeks from the NOrdic Rheumatic Diseases Strategy Trials And Registries (NORD-STAR) trial's conventional treatment arm
Primary result · Adjusted CDAI remission ≤2.8Result — go to the resultRisk difference 19% CI 2–35Authors' conclusion
In treatment-naïve patients with early rheumatoid arthritis, triple therapy and mandatory glucocorticoid joint injections had numerically better clinical outcomes, fewer withdrawals, fewer adverse events, and lower cumulative dose of glucocorticoids, but slightly worse radiographic outcomes than treatment with methotrexate and oral prednisolone.
Study context
- Population
- Treatment-naïve patients with early RA in the active conventional arm of the NORD-STAR trial78% vs
- Participants
- 137 vs 80
- Comparison
- Triple therapy (MTX, SSZ, HCQ) plus mandatory intra-articular GC injections vs MTX plus oral prednisolone
- Oraln = 137reference
- Injectionn = 80
- Primary endpoint
- Adjusted CDAI remission ≤2.8 rate (risk difference)
- Follow-up
- 48 weeks
Methodological detailsprespecified nonrandomised subgroup analysis, logistic regression with several approaches for handling missing outcomes
- Prespecified nonrandomised subgroup analysis
- Logistic regression with several approaches for handling missing outcomes
Primary result
Adjusted CDAI remission ≤2.8
Risk difference
19%
CI 2–35
By group
Injectionvs Oral
risk difference 19% (CI 2–35)
As reported in the abstract
Further findings
| Outcome | Oral | Injection |
|---|---|---|
| Radiographic progression (Δtotal van der Heijde-modified Sharp Score) · 48 weeks | adjusted mean 0.26 (95% CI 0.08–0.43) | adjustedd mean 0.80 (95% CI 0.55–1.05) |
| Cumulative dose of oral/intra-articular GC | median 1905 mg prednisolone | median 165 mg |
Safety
Infections
Original publication
Treatment with methotrexate plus oral prednisolone versus triple therapy (methotrexate/sulfasalazine/hydroxychloroquine) plus intra-articular glucocorticoids in early rheumatoid arthritis: a prespecified nonrandomised subgroup analysis of clinical and radiographic data at 48 weeks from the NORD-STAR trial's conventional treatment arm. Ann Rheum Dis. Published 4 April 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →