Combination Therapy Including Glucocorticoids: The New Gold Standard for Early Treatment in Rheumatoid Arthritis?
Authors: John Richard Kirwan
Journal: Annals of Internal Medicine (2012)

Editorials6 March 2012Combination Therapy Including Glucocorticoids: The New Gold Standard for Early Treatment in Rheumatoid Arthritis?John Richard Kirwan, MDJohn Richard Kirwan, MDFrom University of Bristol Academic Rheumatology Unit, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-5-201203060-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Rheumatoid arthritis can destroy lives and cannot yet be cured. Treatment advances over the past 2 decades have fortunately transformed disease management in the early years after diagnosis, resulting in improved quality of life for most patients. In addition to the wider availability of specialty care, notable developments include biologic therapies, a drive to control underlying disease activity as early as possible, and intelligent use of glucocorticoids. These approaches have substantially reduced symptoms and retarded the progression of radiographic erosions, the tell-tale sign of accumulating joint damage that presages future functional decline (1, 2).There is no doubt that anti–tumor ...References1. Kirwan JR. Links between radiological change, disability, and pathology in rheumatoid arthritis. J Rheumatol. 2001;28:881-6. [PMID: 11327270] MedlineGoogle Scholar2. Scott DL, Pugner K, Kaarela K, Doyle DV, Woolf A, Holmes J, et al. The links between joint damage and disability in rheumatoid arthritis. Rheumatology (Oxford). 2000;39:122-32. [PMID: 10725061] CrossrefMedlineGoogle Scholar3. Singh JA, Christensen R, Wells GA, Suarez-Almazor ME, Buchbinder R, Lopez-Olivo MA, et al. A network meta-analysis of randomized controlled trials of biologics for rheumatoid arthritis: a Cochrane overview. CMAJ. 2009;181:787-96. [PMID: 19884297] CrossrefMedlineGoogle Scholar4. Knevel R, Schoels M, Huizinga TW, Aletaha D, Burmester GR, Combe B, et al. 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Boers M. Understanding the window of opportunity concept in early rheumatoid arthritis [Editorial]. Arthritis Rheum. 2003;48:1771-4. [PMID: 12847667] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Bristol Academic Rheumatology Unit, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-0099.Corresponding Author: John Richard Kirwan, MD, Academic Rheumatology Unit, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HW, United Kingdom; e-mail, John.[email protected]ac.uk. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLow-Dose Prednisone Inclusion in a Methotrexate-Based, Tight Control Strategy for Early Rheumatoid Arthritis Marije F. Bakker , Johannes W.G. Jacobs , Paco M.J. Welsing , Suzanne M.M. Verstappen , Janneke Tekstra , Evelien Ton , Monique A.W. Geurts , Jacobine H. van der Werf , Grietje A. van Albada-Kuipers , Zalima N. Jahangier-de Veen , Maaike J. van der Veen , Catharina M. Verhoef , Floris P.J.G. Lafeber , Johannes W.J. Bijlsma , and Metrics Cited byEfficacy and safety of low-dose glucocorticoids combined with methotrexate and hydroxychloroquine in the treatment of early rheumatoid arthritisBioanalytical method validation for the simultaneous determination of ceftazidime and avibactam in rat plasmaBiological treatment in rheumatoid arthritis: when to stop?The intelligent use of systemic glucocorticoids in rheumatoid arthritisDelayed-release prednisone – a new approach to an old therapyTreatment of early undifferentiated arthritis 6 March 2012Volume 156, Issue 5Page: 390-391KeywordsClinical trialsGlucocorticoid therapyNecrosisPhysical functioningQuality of lifeRheumatoid arthritisRheumatologySystematic reviews ePublished: 6 March 2012 Issue Published: 6 March 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...