Should we use glucocorticoid in Early Rheumatoid Arthritis?: Results at 5 years from the ERA UCLouvain Brussels cohort.
To evaluate the proportion of patients with ERA who have initiated or not GC, to analyse the baseline characteristics, and to assess the clinical benefit and side effects of GC during 5 years of follow-up.We included patients with ERA from the UCLouvain Brussels cohort who met the ACR/EULAR 2010 classification criteria and were naïve to cDMARDs. We retrospectively collected patient characteristics prior to the introduction of cDMARDs with or without GC. Efficiency and serious adverse events were analysed at 6, 12, 36 and 60 months.Data from 474 eligible ERA patients were collected. 180 patients initiated GC compared with 294 who did not.At baseline, the increased CRP is the main factor that favors the initiation of GC followed by smoking, absence of ACPA, prescription of methotrexate as a monotherapy and age.5 years follow-up of DAS28-CRP, HAQ or VAS pain values did not differ between the two groups.We also analysed a subgroup of 139 patients who received >1 g of prednisolone during the 5 years period. We confirmed the same baseline differences and observed in addition more males and higher DAS-28CRP values. During the 5 years follow up, DAS-28CRP, VAS pain and HAQ remained significantly higher in this subgroup. More severe infections were also reported.In our ERA cohort, the initiation of GC treatment does not bring additional benefit for the short and long-term control of the disease. GC was more prescribed in seronegative RA patients with a higher level of inflammation.the authors declare no conflicts of interest.authors declare that the study complies with the Declaration of Helsinki.
Authors: Emilie Sapart, Tatiana Sokolova, Stéphanie de Montjoye, Stéphanie Dierckx, Adrien Nzeusseu, Aleksandra Avramovska, Patrick Durez