Glucocorticoids in Early Rheumatoid Arthritis: Are the Benefits of Joint-Sparing Effects Offset by the Adverse Effect of Osteoporosis? The Effects on Bone in the Utrecht Study and the CAMERA-II Study

被引：11

作者：

Jacobs, Johannes W. G. ^{[1
]}

Bijlsma, Johannes W. J. ^{[1
]}

van Laar, Jacob M. ^{[1
]}

机构：

[1] Univ Med Ctr Utrecht, Dept Rheumatol & Clin Immunol, NL-3508 GA Utrecht, Netherlands

来源：

NEUROIMMUNOMODULATION | 2015年 / 22卷 / 1-2期

关键词：

Glucocorticoid; Rheumatoid arthritis; Prednisone; Radiological joint damage; Osteoporosis; Bone loss; COMPUTER-ASSISTED MANAGEMENT; TIGHT CONTROL STRATEGY; POST HOC ANALYSIS; PREDNISONE THERAPY; DISEASE-ACTIVITY; TRIAL; METHOTREXATE; PLACEBO;

D O I：

10.1159/000362729

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

This paper reviews the clinical effects on bone of 10 mg of prednisone daily in early rheumatoid arthritis, given for 2 years in the Utrecht Study and in the second CAMERA (Computer-Assisted Management in Early Rheumatoid Arthritis) Study, and addresses the question whether there were joint-sparing effects and whether these were offset by adverse effects, especially osteoporosis. We conclude that a 2-year adjunct treatment with 10 mg of prednisone daily increases the benefits of disease-modifying antirheumatic drug therapy and has joint-sparing properties, even if added to the tight control methotrexate-based strategy aiming for remission. Importantly, with good control of inflammation and adequate use of calcium, vitamin D and bisphosphonates - according to national or international guidelines - steroid-induced osteoporosis is rare over 2 years. (C) 2014 S. Karger AG, Basel

引用

页码：66 / 71

页数：6

共 23 条

[1] High disease activity is associated with an increased risk of infection in patients with rheumatoid arthritis
Au, Karen
Reed, George
Curtis, Jeffrey R.
Kremer, Joel M.
Greenberg, Jeffrey D.
Strand, Vibeke
Furst, Daniel E.
[J]. ANNALS OF THE RHEUMATIC DISEASES, 2011, 70 (05) : 785 - 791
[2] Are switches from oral to subcutaneous methotrexate or addition of ciclosporin to methotrexate useful steps in a tight control treatment strategy for rheumatoid arthritis? A post hoc analysis of the CAMERA study
Bakker, M. F.
Jacobs, J. W. G.
Welsing, P. M. J.
van der Werf, J. H.
Linn-Rasker, S. P.
van der Veen, M. J.
Lafeber, F. P. J. G.
Bijlsma, J. W. J.
[J]. ANNALS OF THE RHEUMATIC DISEASES, 2010, 69 (10) : 1849 - 1852
[3] Low-Dose Prednisone Inclusion in a Methotrexate-Based, Tight Control Strategy for Early Rheumatoid Arthritis A Randomized Trial
Bakker, Marije F.
Jacobs, Johannes W. G.
Welsing, Paco M. J.
Verstappen, Suzanne M. M.
Tekstra, Janneke
Ton, Evelien
Geurts, Monique A. W.
van der Werf, Jacobine H.
van Albada-Kuipers, Grietje A.
Jahangier-de Veen, Zalima N.
van der Veen, Maaike J.
Verhoef, Catharina M.
Lafeber, Floris P. J. G.
Bijlsma, Johannes W. J.
[J]. ANNALS OF INTERNAL MEDICINE, 2012, 156 (05) : 329 - U138
[4] Glucocorticoid-induced osteoporosis: an update on current pharmacotherapy and future directions
Bultink, Irene E. M.
Baden, Marijke
Lems, Willem F.
[J]. EXPERT OPINION ON PHARMACOTHERAPY, 2013, 14 (02) : 185 - 197
[5] The role of RANK ligand/osteoprotegerin in rheumatoid arthritis
Geusens, Piet
[J]. THERAPEUTIC ADVANCES IN MUSCULOSKELETAL DISEASE, 2012, 4 (04) : 225 - 233
[6] Gravallese EM, 2000, ARTHRITIS RHEUM-US, V43, P2143, DOI 10.1002/1529-0131(200010)43:10<2143::AID-ANR1>3.3.CO
[7] 2-J
[8] Jacobs JWG, 2012, CLIN EXP RHEUMATOL, V30, pS39
[9] Followup radiographic data on patients with rheumatoid arthritis who participated in a two-year trial of prednisone therapy or placebo
Jacobs, JWG
van Everdingen, AA
Verstappen, SMM
Bijlsma, JWJ
[J]. ARTHRITIS AND RHEUMATISM, 2006, 54 (05): : 1422 - 1428
[10] *JOINT COMM MED RE, 1954, BMJ-BRIT MED J, V1, P1223

← 1 2 3 →