What is low-dose corticosteroid therapy in juvenile idiopathic arthritis? A worldwide, questionnaire-based survey

Objective: To determine pediatric rheumatologists' personal definitions of systemic low-dose, longterm (> 4 weeks) corticosteroid therapy of juvenile idiopathic arthritis (JIA). Methods: Pediatric rheumatologists from America, the Near East (Israel), Au stralia and Europe were asked for their personal definition of a low-dose l ong-term corticosteroid therapy of JIA with the aid a standardized question naire. Results: Of 99 questionnaires returned, 92 were evaluable. The dosage still considered low turned out to be 0.26 +/- 0.14 mg prednisolone/kgBW/day (mi n-max = 0.04-0.50 mg, n = 92). Higher dosages were indicated from Northern Europe (0.29 +/- 0.12, n = 9), Western Europe (0.42 +/- 0.14, n = 7), South ern Europe (0.30 +/- 0.14, n = 9), Eastern Europe (0.25 +/- 0.14, n = 6) an d North America (0.33 +/- 0.17, n = 16) than from Central Europe (0.19 +/- 0.09, n = 43). Conclusion: Pediatric rheumatologists' personal definitions of low-dose, lo ng-term corticosteroid therapy vary within a wide range. The reason for the se differences and the impact on patients should be investigated. In additi on, a generally accepted definition for low-dose, long-term corticosteroid therapy should be developed and subsequently examined in studies.