Table 2

Overview of clinical trials*

Study (publication year)Type of GCInitial GC doseTapering schedule
COBRA (1997)Prednisolone60 mg/dayIn 7 weeks to 7.5 mg/day. Stop after 35 weeks†
BeSt (2005)Prednisone60 mg/dayIn 7 weeks to 7.5 mg/day. Stop in 8 weeks after week 28 if DAS persistently ≤2.4
IDEA (2014)Methylprednisolone250 mg intravenous administration onceN.A.
COBRA-light (2015)PrednisoloneArm 1 60 mg/day
Arm 2 30 mg/day		Arm 1: in 7 weeks to 7.5 mg/day
Arm 2: in 9 weeks to 7.5 mg/day
Stop after 32 weeks if DAS <1.6
IMPROVED (2014)Prednisone60 mg/dayIn 7 weeks to 7.5 mg/day. Stop after 20 weeks if DAS <1.6 at 4 months
tREACH (2013)Arm 1: methylprednisolone or kenacort
Arms 2 and 3: prednisone		Arm 1: 120 or 80 mg intramuscular administration once (single dose)
Arms 2 and 3: 15 mg/day		In 10 weeks to 0 mg/day†
CareRA (2017)Prednisone

  • COBRA Classic

  • COBRA Slim

  • COBRA Avant garde

  • 60 mg/day

  • 30 mg/day

  • 30 mg/day

  • In 7 weeks to 7.5 mg/day, further tapered from week 28 and stop after 34 weeks

  • In 6 weeks to 5 mg/day, further tapered from week 28 and stop after 34 weeks

  • In 6 weeks to 5 mg/day, further tapered from week 28 and stop after 34 weeks

All if DAS28 (CRP) ≤3.2

  • *Replicated from van Ouwerkerk et al. 12

  • †GC tapered and stopped according to protocol, not depending on DAS.

  • CRP, C reactive protein; DAS28, Disease Activity Score based on 28 Joints; GC, glucocorticoid; mg, milligrams; N.A., not applicable.