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Safety of low dose glucocorticoid treatment in rheumatoid arthritis: published evidence and prospective trial data
  1. J A P Da Silva1,
  2. J W G Jacobs2,
  3. J R Kirwan3,
  4. M Boers4,
  5. K G Saag5,
  6. L B S Inês1,
  7. E J P de Koning6,
  8. F Buttgereit7,
  9. M Cutolo8,
  10. H Capell9,
  11. R Rau10,
  12. J W J Bijlsma2
  1. 1Reumatologia, Hospitais da Universidade de Coimbra, Portugal
  2. 2Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, The Netherlands
  3. 3University of Bristol Academic Rheumatology Unit, Bristol Royal Infirmary, Bristol, UK
  4. 4Department of Clinical Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
  5. 5Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, USA
  6. 6Leiden University Medical Centre, Departments of Nephrology and Endocrinology, Leiden, The Netherlands
  7. 7Charité Universitätsmedizin Berlin, Germany
  8. 8Research Laboratory and Division of Rheumatology, Department of Internal Medicine, University of Genova, Italy
  9. 9Centre for Rheumatic Diseases, Royal Infirmary Glasgow, Scotland, UK
  10. 10Department of Rheumatology, Evangelisches Fachkrankenhaus, Ratingen, Germany
  1. Correspondence to:
    Professor J A P Da Silva
    Reumatologia. Hospitais da Universidade, 3000-075 Coimbra, Portugal; jdasilva{at}


Adverse effects of glucocorticoids have been abundantly reported. Published reports on low dose glucocorticoid treatment show that few of the commonly held beliefs about their incidence, prevalence, and impact are supported by clear scientific evidence. Safety data from recent randomised controlled clinical trials of low dose glucocorticoid treatment in RA suggest that adverse effects associated with this drug are modest, and often not statistically different from those of placebo.

  • BMD, bone mineral density
  • COBRA, combination treatment in early rheumatoid arthritis (trial)
  • GC, glucocorticoid(s)
  • GI, gastrointestinal
  • NSAIDs, non-steroidal anti-inflammatory drugs
  • RA, rheumatoid arthritis
  • SLE, systemic lupus erythematosus
  • glucocorticoids
  • rheumatoid arthritis
  • adverse effects

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  • Published Online First 17 August 2005

  • Competing interest: None.