Low dose glucocorticoids for inhibiting radiological progression in rheumatoid arthritis: a systematic review / 中华风湿病学杂志

ABSTRACT

Objectives To evaluate the inhibitory effect of low dose glucocorticoid on progression of radiological damage in rheumatoid arthritis by systematic review.MethodsA search of MEDLINE (from 1966 to April 2010),Embase(from 1966 to April 2010),Cochrane Library(2 Issue,2010),CBM disc,CNKI,WANFANG and VIP Database was undertaken to collect randomized controlled trials published before April 2010 based on the Cochrane Collaboration recommendations.Additional reports were identified from the reference lists.Statistical analysis was performed with RevMan 5.0 software.ResultsEleven studies that met the inclusion criteria,in which 1395 patients,were included.Meta-analysis showed that the standardised mean difference in progression was 0.40 (95％CI 0.27～0.54 ) in favour of glucocorticoids over the first year.In studies that lasted for 2 years,the standardised mean difference in progression in favour of glucocorticoids at 1 year was -0.39[95％CI(-0.50～-0.27)] and was -0.73[95％CI(-1.29～-0.16)] at 2 years.All studies except one showed benefit of glucocorticoids treatment.ConclusionsThe results of this study has shown that low dose glucocorticoids can substantially reduce the progression rate of erosion in rheumatoid arthritis.