Key clinical point: Initial treatment with methotrexate (MTX) and glucocorticoids (GC) bridging reduced chronic use of the nonsteroidal anti-inflammatory drug (NSAID) and analgesics compared with MTX treatment alone in patients with early rheumatoid arthritis (eRA) considered to have a favorable prognosis.
Major finding: The number of patients with a daily chronic intake of NSAIDs was significantly lower in MTX monotherapy along with step-down GC vs. MTX monotherapy without oral GC group (14% vs. 40%; P less than .01). Even after correcting for previous chronic analgesic use and baseline pain, patients treated with MTX and step-down GCs had an 83% lower hazard of chronic use of NSAID or analgesic ( P less than .001).
Study details: Findings are from a post hoc analysis of the CareRA trial of 90 patients with eRA and favorable risk profile. Patients were randomly allocated to either MTX monotherapy without oral GC (n=47) or MTX monotherapy along with step-down GC (n=43).
Disclosures: The CareRA trial was funded by a Flemish governmental grant. All the authors declared no conflicts of interest.
Source: Pazmino S et al. RMD Open. 2021 May 24. doi: 10.1136/rmdopen-2021-001615 .