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• Glucocorticoids in Rh A.
  Tony S Russell
  Published on: 18 December 2003

• Published on: 18 December 2003

  Glucocorticoids in Rh A.

  • Tony S Russell, Professor Med

  Dear Editor

  The recent leader was well balanced and comprehensive.[1]

  However, there was no mention of why they are used and by whom. Thus, the mortality data from ARAMIS and other dara-bases showing an increased mortality in rheumatoid patients taking prednisone is acceptable if it's reserved for the more severe patient. The published evidence suggests to me that use is more physician determined than pa...

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  Dear Editor

  The recent leader was well balanced and comprehensive.[1]

  However, there was no mention of why they are used and by whom. Thus, the mortality data from ARAMIS and other dara-bases showing an increased mortality in rheumatoid patients taking prednisone is acceptable if it's reserved for the more severe patient. The published evidence suggests to me that use is more physician determined than patient. Thus, some prescribe them frequently or even routinely and some rarely, if ever. If this is true, then the longer-term mortality data does warrant serious concern. The clinical description of the efficacy of "biologics" often includes a successful decrease -or discontinuation-of steroids. This appears to be widely accepted as a beneficial outcome,and suggests that,despite the "controversy" most of us know the right answer!

  Reference

  (1) J W J Bijlsma, M Boers, K G Saag, and D E Furst. Glucocorticoids in the treatment of early and late RA Ann Rheum Dis 2003; 62: 1033-1037.

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  Conflict of Interest:
  None declared.

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