BMJ 1998;316:789-790 ( 14 March )

Editorials

Corticosteroids in rheumatoid arthritis

Effective anti-inflammatory agents but doubts about safety remain

Papers p 811

The first 150 words of the full text of this article appear below.

The millennium brings with it the 50th anniversary of Hench's discovery that corticosteroids might be used to treat rheumatoid arthritis.1 Attitudes towards such use have waxed and waned since then. Initial hope that steroids might dramatically alter the long term course of the disorder gave way to a recognition of the serious adverse effects that accompany high dose treatment. As a result the use of low dose corticosteroids in arthritis remains highly controversial.

Corticosteroids are used widely in medicine today. A recent survey in general practice found that 1.4% of patients aged over 54 were using corticosteroids at a mean dose of 8 mg daily2: rheumatoid arthritis was the indication in 23% of cases. Although rheumatologists claim to use steroids relatively infrequently, audits of patients attending outpatient departments suggest a high prevalence of use (as great as 80%). 3 4 What, then, is the quality of the evidence to support the use of . . . [Full text of this article]
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Relevant Article

Meta-analysis of short term low dose prednisolone versus placebo and non-steroidal anti-inflammatory drugs in rheumatoid arthritis
Peter C Gøtzsche and Helle Krogh Johansen
BMJ 1998 316: 811-818. [Abstract] [Full Text] [PDF]

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