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Combination Therapy Including Glucocorticoids: The New Gold Standard for Early Treatment in Rheumatoid Arthritis?

2012; American College of Physicians; Volume: 156; Issue: 5 Linguagem: Inglês

10.7326/0003-4819-156-5-201203060-00014

1539-3704

John Kirwan,

Autoimmune and Inflammatory Disorders Research

Editorials6 March 2012Combination Therapy Including Glucocorticoids: The New Gold Standard for Early Treatment in Rheumatoid Arthritis?John Richard Kirwan, MDJohn Richard Kirwan, MDFrom University of Bristol Academic Rheumatology Unit, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-5-201203060-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Rheumatoid arthritis can destroy lives and cannot yet be cured. Treatment advances over the past 2 decades have fortunately transformed disease management in the early years after diagnosis, resulting in improved quality of life for most patients. In addition to the wider availability of specialty care, notable developments include biologic therapies, a drive to control underlying disease activity as early as possible, and intelligent use of glucocorticoids. These approaches have substantially reduced symptoms and retarded the progression of radiographic erosions, the tell-tale sign of accumulating joint damage that presages future functional decline (1, 2).There is no doubt that anti–tumor ...References1. Kirwan JR. Links between radiological change, disability, and pathology in rheumatoid arthritis. J Rheumatol. 2001;28:881-6. [PMID: 11327270] MedlineGoogle Scholar2. Scott DL, Pugner K, Kaarela K, Doyle DV, Woolf A, Holmes J, et al. The links between joint damage and disability in rheumatoid arthritis. Rheumatology (Oxford). 2000;39:122-32. [PMID: 10725061] CrossrefMedlineGoogle Scholar3. Singh JA, Christensen R, Wells GA, Suarez-Almazor ME, Buchbinder R, Lopez-Olivo MA, et al. A network meta-analysis of randomized controlled trials of biologics for rheumatoid arthritis: a Cochrane overview. CMAJ. 2009;181:787-96. [PMID: 19884297] CrossrefMedlineGoogle Scholar4. Knevel R, Schoels M, Huizinga TW, Aletaha D, Burmester GR, Combe B, et al. 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Effects of glucocorticoids on radiological progression in rheumatoid arthritis. Cochrane Database Syst Rev. 2007;:CD006356. [PMID: 17253590] MedlineGoogle Scholar12. Graudal N, Jürgens G. Similar effects of disease-modifying antirheumatic drugs, glucocorticoids, and biologic agents on radiographic progression in rheumatoid arthritis: meta-analysis of 70 randomized placebo-controlled or drug-controlled studies, including 112 comparisons. Arthritis Rheum. 2010;62:2852-63. [PMID: 20560138] CrossrefMedlineGoogle Scholar13. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, van Zeben D, Kerstens PJ, Hazes JM, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized, controlled trial. Arthritis Rheum. 2005;52:3381-90. [PMID: 16258899] CrossrefMedlineGoogle Scholar14. van Tuyl LH, Plass AM, Lems WF, Voskuyl AE, Kerstens PJ, Dijkmans BA, et al. 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Low-dose prednisone inclusion into a methotrexate-based, tight control strategy for early rheumatoid arthritis. A randomized trial. Ann Intern Med. 2012;156:329-39. LinkGoogle Scholar18. Kirwan JR. The effect of glucocorticoids on joint destruction in rheumatoid arthritis. The Arthritis and Rheumatism Council Low-Dose Glucocorticoid Study Group. N Engl J Med. 1995;333:142-6. [PMID: 7791815] CrossrefMedlineGoogle Scholar19. Landewé RB, Boers M, Verhoeven AC, Westhovens R, van de Laar MA, Markusse HM, et al. COBRA combination therapy in patients with early rheumatoid arthritis: long-term structural benefits of a brief intervention. Arthritis Rheum. 2002;46:347-56. [PMID: 11840436] CrossrefMedlineGoogle Scholar20. Jacobs JW, van Everdingen AA, Verstappen SM, Bijlsma JW. Followup radiographic data on patients with rheumatoid arthritis who participated in a two-year trial of prednisone therapy or placebo. Arthritis Rheum. 2006;54:1422-8. [PMID: 16645970] CrossrefMedlineGoogle Scholar21. Boers M. Understanding the window of opportunity concept in early rheumatoid arthritis [Editorial]. Arthritis Rheum. 2003;48:1771-4. [PMID: 12847667] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Bristol Academic Rheumatology Unit, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0099.Corresponding Author: John Richard Kirwan, MD, Academic Rheumatology Unit, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, United Kingdom; e-mail, John.[email protected]ac.uk. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLow-Dose Prednisone Inclusion in a Methotrexate-Based, Tight Control Strategy for Early Rheumatoid Arthritis Marije F. Bakker , Johannes W.G. Jacobs , Paco M.J. Welsing , Suzanne M.M. Verstappen , Janneke Tekstra , Evelien Ton , Monique A.W. Geurts , Jacobine H. van der Werf , Grietje A. van Albada-Kuipers , Zalima N. Jahangier-de Veen , Maaike J. van der Veen , Catharina M. Verhoef , Floris P.J.G. Lafeber , Johannes W.J. Bijlsma , and Metrics Cited byEfficacy and safety of low-dose glucocorticoids combined with methotrexate and hydroxychloroquine in the treatment of early rheumatoid arthritisBioanalytical method validation for the simultaneous determination of ceftazidime and avibactam in rat plasmaBiological treatment in rheumatoid arthritis: when to stop?The intelligent use of systemic glucocorticoids in rheumatoid arthritisDelayed-release prednisone – a new approach to an old therapyTreatment of early undifferentiated arthritis 6 March 2012Volume 156, Issue 5Page: 390-391KeywordsClinical trialsGlucocorticoid therapyNecrosisPhysical functioningQuality of lifeRheumatoid arthritisRheumatologySystematic reviews ePublished: 6 March 2012 Issue Published: 6 March 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...