Seven-year tolerability profile of glucocorticoids use in early rheumatoid arthritis: data from the ESPOIR cohort.
Ann Rheum Dis
; 76(11): 1797-1802, 2017 Nov.
Article
em En
| MEDLINE
| ID: mdl-28213564
ABSTRACT
OBJECTIVE:
To explore the 7-year tolerability profile of glucocorticoids (GC) for early rheumatoid arthritis (RA).METHODS:
We examined data for 602 patients with RA from the early arthritis Etude et Suivi des POlyarthrites Indifférenciées Récentes (ESPOIR) cohort (<6â months disease duration) stratified into two groups with or without GC treatment at least once during follow-up (median 7â years (IQR 0.038-7.65)). The main outcome was a composite of death, cardiovascular disease (including myocardial ischaemia, cerebrovascular accident and heart failure), severe infection and fracture.RESULTS:
Among the 602 patients with RA (476 women (79%), mean age 48±12â years), 386 with GC (64.1%) received low-dose prednisone (mean 3.1±2.9â mg/day for the entire follow-up) 263 started GC during the first 6â months (68%), and the mean duration of total GC treatment was 1057±876â days. As compared with patients without GC (216 (35.9%)), those with GC showed greater use of non-steroidal anti-inflammatory drugs, synthetic and biological disease-modifying antirheumatic drugs and had more active disease disability, higher C reactive protein and anticitrullinated protein antibody levels. Among 65 events (7 deaths, 14 cardiovascular diseases, 19 severe infections and 25 fractures), 44 and 21 occurred in patients with and without GC (p=0.520). Infections were more frequent, although not significantly, in patients with than without GC (p=0.09). On weighted Cox proportional-hazards analysis, with use of propensity score and inverse-probability-of-treatment weighting, and including age, gender, history of hypertension and GC treatment, outcomes did not differ with and without GC (p=0.520; HR=0.889; 95% CI 0.620 to 1.273).CONCLUSIONS:
This 7-year analysis of the ESPOIR cohort supports the good safety profile of very low-dose GC for early active RA.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Antirreumáticos
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Glucocorticoides
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Ann Rheum Dis
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
França