Management of early RA - summary of recommendations - steroid therapy - SIGN

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ish Intercollegiate Guidelines NetworkManagement of Early Rheumatoid ArthritisSummary of recommendationsCorticosteroid therapyOral corticosteroids are not recommended for routine use, as there isno sustained clinical or functional benefit and there is high risk oftoxicity with long term use. Inform patients of the risks of corticosteroids prior to prescription and issue steroid warning card. Intramuscular corticosteroid allows control of dose and duration of therapy and may be preferable to oral therapy. Oral corticosteroids should be withdrawn slowly to avoid rebound flare of symptoms.The lowest possible dose of corticosteroid should be used for theshortest possible time.Monitor patients closely for adverse corticosteroid effects. Be alertto the possibility of diabetes, cataract and infection. Inform patients notpreviously infected of the danger of chicken pox/shingles exposureEnsure adequate surveillance and prophylaxis of osteoporosis inpatients taking oral corticosteroids.http://www.sign.ac.uk/guidelines/fulltext/48/summary.html