Glucocorticoids for the treatment of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) can improve clinical efficacy but can also cause multiple system adverse reactions, according to findings from a study published in the Annals of Palliative Medicine.

Although most meta-analysis studies on glucocorticoid therapy for RA focus on their effect on bone mineral density and other indicators and the complication rate after treatment of SLE, there are relatively few meta-studies on the efficacy and safety of glucocorticoids in patients with RA and SLE. Therefore, researchers performed a meta-analysis to explore the efficacy of glucocorticoids in the treatment of RA and SLE to provide a theoretical basis for the clinical treatment of patients.

Randomized controlled trials of the clinical efficacy of glucocorticoids in the treatment of RA and SLE were screened for meta-analysis and 11 studies were included that involved 1298 participants. It was found that the cardiovascular system (P=.53), respiratory system (P=.24), nervous system (P=.8), visual impairment (P=.25), endocrine system (P=.0003), digestive system (P=.28), genitourinary system (P=.92), blood system (P=.63), infection status (P=.06), clinical efficacy (P=.0009), pain (P=.5), and joint swelling score (P=.88) of experimental group after treatment were all superior when compared with control patients.


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However, the skin and mucous membranes (P=.54), musculoskeletal (P=.63), radiation injury (P=.03), and C-reactive protein (CRP) level (P<.00001) of experimental group were inferior to those of a control group.

Limitations to this study, as cited by the investigators, include possible large publication bias of the documents.

The study authors concluded, “Glucocorticoids in the treatment of RA and SLE can improve the clinical efficacy, but it was easy to cause multiple system adverse reactions.” They added, “Therefore, in future work, it remains necessary to recruit larger samples and high-quality glucocorticoids to verify its clinical effects for RA and SLE.”

Reference

Sun T, Wang J, Zhang R, Li Y. A systematic review and meta-analysis: effects of glucocorticoids on rheumatoid arthritis and systemic lupus erythematosus. Ann Palliat Med. 2021;10(7):7977-91. doi:10.21037/apm-21-1485