Table 1

Randomised controlled trials of glucocorticoids added to DMARDs in early arthritis

StudyNGlucocorticoid regimenTrial duration (years)OutcomeResults in glucocorticoids group (%)Results in control group (%)p Value
Machold, 20109383Single IM 120 mg methylprednisolone1Drug-free persistent clinical remission (both at 12 and 52 weeks)
Fedorenko, 201110141Prednisolone 10 mg/day or Prednisolone 10 mg/day+methylprednisolone 1 g IV first day1‘Clinical EULAR remission’ at 12 weeks*21.3 (oral GC)3.10.027
28.6 (oral GC+IV GC)0.006
‘Clinical EULAR remission’ at 52 weeks*37.5 (oral GC)11.40.012
29.4 (oral GC+IV GC)0.133
Montecucco, 201211
Todoerti, 201012
220Prednisone 12.5 mg/day for 2 weeks tapered to 6.25 mg/day for the follow-up period†1DAS28≤3.2 at 52 weeks80.275.50.44
DAS28<2.6 at 52 weeks44.827.80.02
Bakker, 201213236Prednisone 10 mg/day†2ACR70 at 104 weeks3819,0.002
SHS erosion score at 104 weeks0 (0–0)0 (0–2)0.022
SHS total score at 104 weeks0 (0–3)0 (0–4)0.32
  • Studies were of glucocorticoids added to MTX except for the study of Machold et al concerning glucocorticoids added to no other therapy, NSAIDs or DMARDs at the investigators’ discretion.

  • *Study only reported as an abstract at the 2011 EULAR congress: definition of ‘Clinical EULAR remission’ unclear.

  • †Tight control, treatment to target.

  • DAS28, Disease Activity Score in 28 joints; DMARDs, disease-modifying antirheumatic drugs; GC, glucocorticoids; IM, intramuscular; IV, intravenous; MTX, methotrexate; NSAIDs, non-steroidal anti-inflammatory drugs; SHS, median Sharp–van der Heijde score (interquartile range).