A RETROSPECTIVE ANALYSIS OF GLUCORTICOSTEROIDS UTILIZATIONAMONG PATIENTS WITHRHEUMATOID ARTHRITIS
Authors:   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., El Ouardi Najlae , Taoubane Laila ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., Sadni Siham ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., El Hani Hajar ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., Julien Djossou H. ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., Ahmed Ghassem Mohamed ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., Majjad Abderrahim ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., Toufik Hamza ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., Rezqi Asmaa ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., Mounach Aziza ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., Achemlal Lahsen ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco., Bezza Ahmed ,   Department of Rheumatology, Military Hospital Mohammed V, Ibn Sina University Hospital, Rabat, Morocco.
Published: July 2022

Background:Glucocorticoid therapy is used widely in patients with rheumatoid arthritis(RA). Recently, treatment guidelines recommendglucorticosteroids (GCs) use in low dose and for a short time in RA. However, for many patients, it is still difficult to withdraw GCs once initiated. Objectives: to analyzeGCs utilization in RA patients and to evaluate the effects of increasing cumulativedoses on theprevalence of potential GCs related adverse events. Methods:we enrolled patients with RA. Corticoid exposure was defined: duration (short â‰¤6 months and long >6months), average daily dose (low â‰¤ 2.5mg, medium 2.5mg < â‰¤ 7.5mg and high > 7.5mg). Effect of increasing cumulative GCs doses on adverse events development were analyzed usingchi-square test or Fischers exact test. Regression models were used to identify the factors favoring GCs discontinuation. Results:a total of 168 RA were included (84 patients usedbDMARDs). The median of cumulative GCs dose was 14400mg. the majority of GCs users were prescribed high doseof GCs (54.3%) for a long duration (98.7%). Skin events (71.5%) were the majorside effects. Higher cumulative GCs doses compared with lower doses had increased incidence of diabetes, cardiovascular and ophthalmologic events (p=0.04, p=0.001, p=0.02 respectively).The prevalence of RA patients having withdrawnGCs was 38.7%. It was negatively associated in multivariable regression with RA duration (OR:0.8, IC95%:0.6-0.9). Surprisingly, there was no association in logistic regression with bDMARD use. Conclusions:GCs were used with high dose and for a long duration for the majority of our RA patients.