Application And Analysis Of Low-dose Prednisone In Rheumatoid Arthritis

Objective: It is controversial whether the rheumatoid arthritis patients should receive corticosteroid therapy. The aim of this study was to determine the functions of low dose glucocorticoids on disease activity, bone mineral density in rheumatoid arthritis prior to and 6 months after adding low-dose prednisone(< 10mg/d) treatment.Methods: One hundred and nine rheumatoid arthritis patients receiving 10mg/d of prednisone or less for at least the previous 6 consecutive months were studied. Patients were evaluated prior to and 6 months. Disease activity measures including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), C3, C4 were documented. BMD of the femoral neck, lumbar spine and average BMD of body was measured using dual energy X-ray absorptiometry. The dose of prednisone was adjusted according to the level of pain at each visit. Our data was collected in a database made in the SPSS program. Wilcoxon's signed ranked test was used to compare BMD prior to and 6 months after receiving prednisone. In the same way, disease activity measures were compared prior to and 6 months. Pearson's correlation coefficient was used to correlate changes in BMD and changes in disease activity measures of rheumatoid arthritis.Results: The mean BMD of the body prior to and 6 months were 1.088±0.087 and 1.079±0.092, (P = 0.054). The mean BMD at the LS prior to and 6 months were 0.962±0.178 and 0.943±0.163, (P = 0.249). The mean BMD at the FN prior to and 6 months were 0.881±0.142 and 0.862±0.126, (P = 0.143). The mean BMD of the body of C group prior to and 6 months were 0.957±0.179 and 0.846±0.168, (P=0.016). The mean BMD of the body of A and B group prior to and 6 months were 1.061 ±0.125 and 1.058±0.118; 1.034±0.111 and 1.028±0.108; P = 0.882, 0.124, respectively. The changes of marker of inflammation were statistically significant (P<0.05). There was a significant correlation between the changes of mean BMD of body and FN and the markers of inflammation such as ESR, CRP, but not with BMD of LS. There was not correlationbetween changes of BMD and MTX.Conclusions: The conception of low-dose glucocorticoids means prednisone no more than 7.5mg/d or doses of other equivalent corticosteroids. Low-dose glucocorticoids have disease-modifying properties. It is effective and secure to prescribe low-dose glucocorticoids and MTX for rheumatoid arthritis. But it would be prudent to prescribe low-dose glucocorticoids for postmenopausal women.