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Abstract
Corticosteroid (steroid) use is common but controversial in rheumatoid arthritis (RA).
Some observational studies suggest that mortality might be increased with steroid
use, and several large retrospective reviews indicate that long-term low-dose steroid
use is a significant independent predictor of numerous, potentially serious adverse
events. Both cumulative and average steroid dose are independent important adverse-event
predictors. There is a lack of long-term data on the efficacy of steroid therapy,
since few studies exceed 1 year in follow-up. Most of the short- and medium-term steroid
studies reveal similar or improved disease activity when compared with control therapy.
A meta-analysis of the few randomized studies available showed that steroids were
equivalent or slightly better than placebo and active controls in improving RA disease
activity. Studies of disease-modifying effects have not produced definitive results.
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© 1997 Published by Elsevier Inc.
