BMJ 1998;316:1606 ( 23 May )

Letters

Intermittent low dose prednisolone is safe in rheumatoid arthritis

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

EDITOR---In our meta-analysis we concluded that doses of prednisolone of =<15 mg daily may be used intermittently in patients with rheumatoid arthritis, particularly if the disease cannot be controlled by other means.1

An accompanying editorial by Dennison and Cooper warned that doubts about the safety of this treatment remained.2 They also mentioned a number of side effects reported in a narrative review by Caldwell and Furst which we also cited in our meta-analysis (reference number 57). They complained that we had not subjected our analysis of side effects to "the full weight of the evidence based approach."2 How could we have served readers better than by collecting systematically all available results of randomised trials and matched cohort studies. Evidence based medicine relies on applying strict and explicit methodological criteria to the searching and synthesizing of the literature. This was not done in the editorial.

Dennison and Cooper argued that . . . [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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