Clinical study of high-dose glucocorticoid on early active rheumatoid arthritis / 中国医师进修杂志

ABSTRACT

Objective To investigate the effects and adverse reactions of high-dose glucocorticoid on early active rheumatoid arthritis patients.Methods The early active rheumatoid arthritis patients were randomly divided into three groups:high dose group (16 patients,with large doses of glucocorticoid therapy),low dose group (17 patients,with small doses of glucocorticoid therapy),and control group (41 patients,with no glucocorticoid therapy).Compared the differences among the three groups.Results The changes in the three groups were different in joint pain,joint swelling,morning stiffness,erythrocyte sedimentation rate,rheumatoid factor and C-reactive protein (P ＜ 0.05).The high dose group was significantly better than the other two groups in the above variables alleviating,in the 1 week after the treatment.The changes in the three groups had no significant difference of bone mineral density,Larsen hip score (P＞ 0.05).The NSAIDs days in the control group was significantly longer than the high dose group,low dose group [(51.17 ± 2.56) d vs.(14.16 ± 0.71) d,(26.50 ± 1.59) d],the difference was statistically significant (P ＜ 0.05).Rate of weight gain in the high dose group,low dose group was significantly higher than the control group [5/16,4/17 vs.4.9％ (2/41)],the difference was statistically significant (P ＜ 0.05).Body weight increased in the high dose group and low dose group occurred mainly in the following 1.5 months of therapy,with the discontinuation of cortices-teroids,weight gradually fell to normal.Gastrointestinal discomfort incidence in the control group was significandy higher than that in the high dose group,low dose group [51.2％ (21/41) vs.2/16,3/17],the difference was statistically significant (P＜ 0.05).Conclusions High-dose glucocorticoid can rapidly relieve clinical symptoms and inflammation in early active rheumatoid arthritis patients.High-dose corticosteroids do not bring too many side effects to patients but weight gain,and it reduces the patients' gastrointestinal discomfort greatly,because of the decrease use of NSAIDs.