Short-term low-dose corticosteroids vs placebo and nonsteroidal antiinflammatory drugs in rheumatoid arthritis

Pc, Gøtzsche; Johansen, H.

doi:10.1002/14651858.cd000189

Cited by 43 publications

(49 citation statements)

References 39 publications

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“…At low doses and even with long administration, their role as DMARDs is gaining ground. Its beneWt is because of its anti-inXammatory eVect [7,56,57], NSAIDs due to their analgesic, anti-inXammatory and antipyretic eVect [7,[10][11][12][13], paracetamol due to its analgesic and antipyretic eVect [58,59] and amitriptyline due to its beneWt in depression and neuropathic pain [60,61] have all found a place in the treatment of rheumatoid arthritis as supportive drugs.…”

Section: Discussionmentioning

confidence: 99%

Causes of DMARD withdrawal following ADR within 6 months of initiation among Indian rheumatoid arthritis patients

et al. 2010

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The present study was conducted in Indian rheumatoid arthritis (RA) patients prescribed disease-modifying anti-rheumatic drugs (DMARDs) to determine the incidence and type of adverse drug reactions (ADRs) leading to their withdrawal in the initial 6 months of therapy. This was considered important as pharmacogenetic variations in the pattern of RA in different populations and genetic differences in efficacy and safety to drugs demand separate studies to be conducted in different populations. Hospital records were used to identify 1,000 consecutive patients with RA fulfilling the American College of Rheumatology criteria and having at least 6-month follow-up. Age, gender, duration of arthritis, drug usage and ADR-related drug withdrawal were recorded from the charts. Most of the patients were put on single DMARD. Combined use of DMARD was less frequent and non-use of DMARD was common; however, disease control was good. The commonest DMARD used in our hospital was hydroxychloroquine 444 (44%) and the commonest combination used was methotrexate with hydroxychloroquine by 55 (6%). Sulphasalazine use showed preference to young and males. Supportive drugs used were NSAIDs by 883 (88%), corticosteroids by 646 (65%), paracetamol by 594 (59%) and amitriptyline by 88 (9%). Incidence of ADR-related DMARD withdrawal was maximum with leflunomide 2/15 (13.33%) followed by methotrexate 9/116 (7.76%), sulphasalazine 6/185 (3.24%), chloroquine 3/131 (2.29%) and hydroxychloroquine 8/444 (1.8%). Severity and symptomatology of disease, genetic pattern of patients, financial status, previous experience of the clinicians and patients, availability of drugs, patient expectations and compliance were the main factors that lead to a difference in pattern of therapy in our patients compared to other population.

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Section: Discussionmentioning

confidence: 99%

Causes of DMARD withdrawal following ADR within 6 months of initiation among Indian rheumatoid arthritis patients

et al. 2010

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“…GCs have a dramatic effect on different clinical inflammatory parameters in the majority of RA patients (Gotzsche and Johansen, 2004). A smaller group however does not respond to GC therapy and has been classified as cortico resistant (Chikanza and Panayi, 1993;Jacobs et al, 2001).…”

Section: Gcr B In Rheumatoid Arthritismentioning

confidence: 99%

Glucocorticoid receptor β in acute and chronic inflammatory conditions: Clinical implications

Goecke

Guerrero

2006

Immunobiology

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“…As prednisolone is highly effective, short term placebo controlled trials to study the clinical effect of low dose prednisolone or other oral corticosteroids are no longer necessary. If additional relevant trials are performed in future—, for example, comparison of steroids with non-steroidal anti-inflammatory drugs—they will be included in the electronic version of this meta-analysis,58 which will be continuously updated.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of short term low dose prednisolone versus placebo and non-steroidal anti-inflammatory drugs in rheumatoid arthritis

Gøtzsche

Johansen

1998

BMJ

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Short-term low-dose corticosteroids vs placebo and nonsteroidal antiinflammatory drugs in rheumatoid arthritis

Cited by 43 publications

References 39 publications

Causes of DMARD withdrawal following ADR within 6 months of initiation among Indian rheumatoid arthritis patients

Causes of DMARD withdrawal following ADR within 6 months of initiation among Indian rheumatoid arthritis patients

Glucocorticoid receptor β in acute and chronic inflammatory conditions: Clinical implications

Meta-analysis of short term low dose prednisolone versus placebo and non-steroidal anti-inflammatory drugs in rheumatoid arthritis

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