A CLINICAL AND BIOCHEMICAL EVALUATION OF PREDNISOLONE IN PATIENTS WITH ACTIVE RHEUMATOID-ARTHRITIS

Fifteen patients with active rheumatoid arthritis who had not previous ly received oral corticosteroids were recruited into an open study usi ng the Leeds Human Model Screening System to assess whether prednisolo ne has any activity as a second-line agent. The daily dose of predniso lone was 10 mg/day, and all patients completed the full study duration of 24 weeks, with only one patient requiring a dose reduction to 7.5 mg. Patients were then recruited into a further open study during whic h dosage reduction of 1 mg/month was attempted. Patients were assessed using six clinical and six laboratory variables, and statistically si gnificant improvement (P<0.01) was seen in seven of 12 variables at 24 weeks. After 48 weeks, two variables showed statistically significant improvement at P<0.01, with improvement in a further four variables s ignificant at P<0.05. This degree of change ranks prednisolone below e stablished Second-line agents such as sodium aurothiomalate and D-peni cillamine but ahead of non-steroidal anti-inflammatory drugs, suggesti ng that in addition to their known anti-inflammatory properties cortic osteroids may have some action as second-line agents.