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Clinical Rheumatology

, Volume 37, Issue 8, pp 2027–2034 | Cite as

Safety and efficacy of alternate-day corticosteroid treatment as adjunctive therapy for rheumatoid arthritis: a comparative study

  • Masei Suda
  • Sachiko Ohde
  • Tokutaro Tsuda
  • Mitsumasa Kishimoto
  • Masato Okada
Original Article

Abstract

Corticosteroids (CSs), used to treat rheumatoid arthritis (RA), confer a risk of adverse events (AEs). This study investigated the safety and efficacy of alternate-day (QOD) CS therapy for RA. All patients (> 18 years) who started oral CS therapy for RA, between 2005 and 2014, at our hospital were retrospectively analysed. The patients were divided into the daily (QD) and QOD CS therapy groups to investigate the rates of CS-related major AEs (infection, diabetes, hypertension, cardiovascular events and fragility fractures) within the first year of treatment. The number of patients free from CS treatment at 1 year and the mean decreases in C-reactive protein (CRP) levels at 1 month were also investigated. In total, 138 patients were analysed (QD group, 68; QOD group, 70). The maximum daily CS dose was not significantly different between the two groups, but the annual cumulative dose was significantly lower in the QOD group (P < 0.01). The infection rate was significantly lower in the QOD group (24.3%) than in the QD group (50.0%; P < 0.01), whereas the other AE rates were similar between the groups. The CS-free rate at 1 year was significantly higher in the QOD group (58.6%) than in the QD group (26.5%; P < 0.01). The mean CRP decreases over 1 month of CS therapy were not significantly different between the groups. QOD CS treatment leads to a lower infection rate and less CS dependence than does daily treatment; both RA treatments are equally effective.

Keywords

Adverse events Corticosteroids Infection Rheumatoid arthritis 

Notes

Acknowledgements

The authors thank Hideki Nakajima for technical support.

Compliance with ethical standards

The study was approved by the Ethics Committee of St. Luke’s International Hospital (approval number, 14-R162).

Disclosures

None.

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Copyright information

© International League of Associations for Rheumatology (ILAR) 2018

Authors and Affiliations

  1. 1.Immuno-Rheumatology Centre, St. Luke’s International HospitalSt. Luke’s International UniversityTokyoJapan
  2. 2.Graduate School of Public Health, OMURA Susumu and Mieko Memorial St. Luke’s Centre for Clinical AcademiaSt. Luke’s International UniversityTokyoJapan

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