Rheumatoid arthritis patients who use corticosteroids frequently over the long term can maintain a low disease activity state but suffer deterioration of their functional capability, Dr. Eiichi Tanaka reported at a poster session at the annual European Congress of Rheumatology.
“A low disease activity state caused by corticosteroid use may not represent a ‘true’ low disease activity state,” explained Dr. Tanaka of Tokyo Women's Medical University, and his associates.
The investigators followed 224 RA patients with a low disease activity state during 2000–2005. The patients had a mean age of 56 years and a mean disease duration of about 8 years, and were enrolled in the study for at least 3 years. Every 6 months, the investigators collected measurements on the Disease Activity Score-28 (DAS-28) and Japanese version of the Health Assessment Questionnaire (J-HAQ).
DAS-28 scores did not change substantially over the course of the study in 135 patients who never used corticosteroids, 33 who used steroids an average of less than 9 months per year, and 56 who took steroids an average of more than 9 months per year. None of the patients had a DAS-28 greater than 3.2 at each assessment.
But long-term functional capacity, as measured by the J-HAQ, declined in the heavy corticosteroid users, improved slightly among moderate corticosteroid users, and improved the most in patients who did not use corticosteroids. Corticosteroid use was the most significant factor contributing to the final J-HAQ score, after adjustment of a multiple linear regression analysis for age, gender, disease duration, initial J-HAQ score, and seasonal effects. A little more than 90% of the patients in each group used disease-modifying antirheumatic drugs during the study.
“Along with the achievement of a low disease activity state, long-term efficacy, long-term functional prognosis, and the quality of remission also need to be considered in the strict control of RA activity,” Dr. Tanaka and his colleagues concluded.
very interesting post. got to go into this deeper..
Boney
Thankyou Lynn, this really does apply to me and I reckon my functional capacity has definitely deteriorated. Thanks again, Janie.
You're welcome Janie. Just trying to share some information.
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