Re: RESEARCH - Lack of benefit over two years of lowdose prednisolone for RA

November 18, 2004

OK, I'm assigning that task to you then, a, LOL!

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Re: [ ] RESEARCH - Lack of benefit over two years of

lowdose prednisolone for RA

Can we send this to every Rheumatologist in our nation?????? Maybe they

will use it with more caution.

As Jennie said, it¹s very useful to give a patient relief while waiting

for

the meds to work, but the side effects are just to severe for long term.

It¹s unfortunate that so many members aren¹t able to get off of

Prednisone

since they have been on it so long that their body no longer

manufactures

it.

a

> ls of the Rheumatic Diseases 2004;63:797-803

>

> EXTENDED REPORT

>

> Lack of radiological and clinical benefit over two years of low dose

> prednisolone for rheumatoid arthritis: results of a randomised

> controlled trial

>

> H A Capell1, R Madhok1, J A Hunter3, D Porter3, E on4, J

Larkin5,

> E A Thomson3, R Hampson1 and F W Poon2 on behalf of the WOSERACT

Group*

>

> Background: Evidence for disease modifying activity of low dose

> corticosteroid treatment in rheumatoid arthritis is contradictory.

> Studies showing radiological benefit suggest that continued treatment

is

> required to sustain the effect.

>

> Objective: To evaluate the effect of low dose oral prednisolone in

early

> rheumatoid arthritis on disease activity over two years.

>

> Design: Double blind placebo controlled trial.

>

> Methods: Patients with rheumatoid arthritis, duration <3 years (n =

> 167), were started on a disease modifying antirheumatic drug (DMARD;

> sulphasalazine) and allocated by stratified randomisation to

> prednisolone 7 mg/day or placebo. Primary outcome measure was

> radiological damage, assessed by the modified Sharp method. Clinical

> benefit was a secondary outcome. A proactive approach to identifying

and

> treating corticosteroid adverse events was adopted. Patients who

> discontinued sulphasalazine were offered an alternative DMARD.

>

> Results: 90 of 257 patients eligible for the study refused to

> participate (more women than men). Of those enrolled, 84% were

> seropositive for rheumatoid factor, median age 56 years, median

disease

> duration 12 months, female to male ratio 1.8:1. Prednisolone was given

> to 84 patients; of these 73% continued prednisolone and 70%

> sulphasalazine at 2 years. Of the 83 patients on placebo, 80%

continued

> placebo and 64% sulphasalazine at 2 years. There were no significant

> differences in radiological score or clinical and laboratory measures

at

> 0 and 2 years.

>

> Conclusions: Low dose prednisolone conferred no radiological or

clinical

> benefit on patients maintained on a DMARD over two years. Low dose

> corticosteroids have no role in the routine management of rheumatoid

> arthritis treated with conventional disease modifying drugs.

>

> http://ard.bmjjournals.com/cgi/content/abstract/63/7/797

November 18, 2004

OK, I'm assigning that task to you then, a, LOL!

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Re: [ ] RESEARCH - Lack of benefit over two years of

lowdose prednisolone for RA

Can we send this to every Rheumatologist in our nation?????? Maybe they

will use it with more caution.

As Jennie said, it¹s very useful to give a patient relief while waiting

for

the meds to work, but the side effects are just to severe for long term.

It¹s unfortunate that so many members aren¹t able to get off of

Prednisone

since they have been on it so long that their body no longer

manufactures

it.

a

> ls of the Rheumatic Diseases 2004;63:797-803

>

> EXTENDED REPORT

>

> Lack of radiological and clinical benefit over two years of low dose

> prednisolone for rheumatoid arthritis: results of a randomised

> controlled trial

>

> H A Capell1, R Madhok1, J A Hunter3, D Porter3, E on4, J

Larkin5,

> E A Thomson3, R Hampson1 and F W Poon2 on behalf of the WOSERACT

Group*

>

> Background: Evidence for disease modifying activity of low dose

> corticosteroid treatment in rheumatoid arthritis is contradictory.

> Studies showing radiological benefit suggest that continued treatment

is

> required to sustain the effect.

>

> Objective: To evaluate the effect of low dose oral prednisolone in

early

> rheumatoid arthritis on disease activity over two years.

>

> Design: Double blind placebo controlled trial.

>

> Methods: Patients with rheumatoid arthritis, duration <3 years (n =

> 167), were started on a disease modifying antirheumatic drug (DMARD;

> sulphasalazine) and allocated by stratified randomisation to

> prednisolone 7 mg/day or placebo. Primary outcome measure was

> radiological damage, assessed by the modified Sharp method. Clinical

> benefit was a secondary outcome. A proactive approach to identifying

and

> treating corticosteroid adverse events was adopted. Patients who

> discontinued sulphasalazine were offered an alternative DMARD.

>

> Results: 90 of 257 patients eligible for the study refused to

> participate (more women than men). Of those enrolled, 84% were

> seropositive for rheumatoid factor, median age 56 years, median

disease

> duration 12 months, female to male ratio 1.8:1. Prednisolone was given

> to 84 patients; of these 73% continued prednisolone and 70%

> sulphasalazine at 2 years. Of the 83 patients on placebo, 80%

continued

> placebo and 64% sulphasalazine at 2 years. There were no significant

> differences in radiological score or clinical and laboratory measures

at

> 0 and 2 years.

>

> Conclusions: Low dose prednisolone conferred no radiological or

clinical

> benefit on patients maintained on a DMARD over two years. Low dose

> corticosteroids have no role in the routine management of rheumatoid

> arthritis treated with conventional disease modifying drugs.

>

> http://ard.bmjjournals.com/cgi/content/abstract/63/7/797

November 18, 2004

paula, my doctor uses it vary carefully... only am i on it til the RA meds start

working...

he is a really good doctor... and so kind and gentle...

rae

Re: [ ] RESEARCH - Lack of benefit over two years of lowdose

prednisolone for RA

Can we send this to every Rheumatologist in our nation?????? Maybe they

will use it with more caution.

As Jennie said, it¹s very useful to give a patient relief while waiting for

the meds to work, but the side effects are just to severe for long term.

It¹s unfortunate that so many members aren¹t able to get off of Prednisone

since they have been on it so long that their body no longer manufactures

it.

a

> ls of the Rheumatic Diseases 2004;63:797-803

>

> EXTENDED REPORT

>

> Lack of radiological and clinical benefit over two years of low dose

> prednisolone for rheumatoid arthritis: results of a randomised

> controlled trial

>

> H A Capell1, R Madhok1, J A Hunter3, D Porter3, E on4, J Larkin5,

> E A Thomson3, R Hampson1 and F W Poon2 on behalf of the WOSERACT Group*

>

> Background: Evidence for disease modifying activity of low dose

> corticosteroid treatment in rheumatoid arthritis is contradictory.

> Studies showing radiological benefit suggest that continued treatment is

> required to sustain the effect.

>

> Objective: To evaluate the effect of low dose oral prednisolone in early

> rheumatoid arthritis on disease activity over two years.

>

> Design: Double blind placebo controlled trial.

>

> Methods: Patients with rheumatoid arthritis, duration <3 years (n =

> 167), were started on a disease modifying antirheumatic drug (DMARD;

> sulphasalazine) and allocated by stratified randomisation to

> prednisolone 7 mg/day or placebo. Primary outcome measure was

> radiological damage, assessed by the modified Sharp method. Clinical

> benefit was a secondary outcome. A proactive approach to identifying and

> treating corticosteroid adverse events was adopted. Patients who

> discontinued sulphasalazine were offered an alternative DMARD.

>

> Results: 90 of 257 patients eligible for the study refused to

> participate (more women than men). Of those enrolled, 84% were

> seropositive for rheumatoid factor, median age 56 years, median disease

> duration 12 months, female to male ratio 1.8:1. Prednisolone was given

> to 84 patients; of these 73% continued prednisolone and 70%

> sulphasalazine at 2 years. Of the 83 patients on placebo, 80% continued

> placebo and 64% sulphasalazine at 2 years. There were no significant

> differences in radiological score or clinical and laboratory measures at

> 0 and 2 years.

>

> Conclusions: Low dose prednisolone conferred no radiological or clinical

> benefit on patients maintained on a DMARD over two years. Low dose

> corticosteroids have no role in the routine management of rheumatoid

> arthritis treated with conventional disease modifying drugs.

>

> http://ard.bmjjournals.com/cgi/content/abstract/63/7/797

>

> I'll tell you where to go!

>

> Mayo Clinic in Rochester

> http://www.mayoclinic.org/rochester

>

> s Hopkins Medicine

> http://www.hopkinsmedicine.org

>

November 18, 2004