LOW-DOSE CORTICOSTEROIDS IN EARLY RHEUMATOID-ARTHRITIS - CAN THESE DRUGS SLOW DISEASE PROGRESSION

The role of corticosteroids in treating rheumatoid arthritis is contro versial, but recourse to the available evidence of efficacy should gui de patient management decisions. Earlier evidence suggested that sympt omatic control could be improved for periods of 6 to 12 months, but no t longer, without increasing doses to unacceptably high levels. The ef fect of corticosteroids on joint destruction has been unclear. Recent findings from a controlled clinical trial show that prednisolone 7.5 m g/day can significantly retard the rate of erosive progression in pati ents with relatively early disease (<2 years' duration). These results have implications for both disease management and our understanding o f he pathogenesis of joint destruction in rheumatoid arthritis.