Patients With Rheumatoid Arthritis See Benefits of Low-Dose Glucocorticoids

A majority of patients and rheumatologists are highly satisfied with the safety and efficacy of low-dose glucocorticoids (GCs) in rheumatoid arthritis (RA), according to study results published in Rheumatology.

Although GCs have an important role in the management of RA, there is still debate on the balance between the efficacy and safety of using GCs in patients with RA.

Using 2 online surveys sent between September 2018 and October 2019 to patients with RA and health professionals with experience in management of GC treatments, investigators collected data on the perspectives of patients and rheumatologists from several countries.

In all, 1221 patients with RA with exposure to GCs completed the patient survey. The patient cohort was 89% women, with a median age of 52 years. The median duration of GC exposure was 3 years, with an average daily dose during the last year of treatment of 5 mg of prednisolone-equivalent. It was noted that 86% considered low-dose GCs to be very effective in the control of symptoms, 73% agreed that GCs improved RA symptoms within days, and 71% agreed that low-dose GC have significant effects.

A total of 414 health professionals (53.6% women; median age, 49 years) completed the rheumatologist survey. All respondents were directly involved in the care or education of patients with RA. Of all rheumatologists surveyed, 75% considered GCs very effective in the control of signs and symptoms of RA; 71% agreed GCs had a rapid onset of action; and 61% agreed that low-dose GCs have significant effect on RA.

As for treatment safety, 47% of patients reported having experienced serious adverse events (AEs) as a result of taking GCs. In the physicians’ survey responses, there were marked differences of opinion regarding the likely prevalence of some AEs associated with treatment low-dose GCs for 2 years.

The study had several limitations, including lack of confirmation of the reported AEs; potential effects of comorbidities and other medications that were not considered; possible selection bias; and large differences between countries in the number of respondents, which may skew the results.

“This study indicates that there is an unmet need for appropriately designed prospective trials that shed light on the real risk associated with low-dose GCs, as well as a need for renovated educational programs on the real benefits and harms of low-dose GCs, for both patients and physicians,” concluded the researchers.

Reference

Santiago T, Voshaar M, de Wit M, et al. Patients’ and rheumatologists’ perspectives on the efficacy and safety of low-dose glucocorticoids in rheumatoid arthritis-an international survey within the GLORIA study. Rheumatology (Oxford). Published online January 4, 2021. doi: 10.1093/rheumatology/keaa785