Short term effects of corticosteroid pulse treatment on disease activity and the wellbeing of patients with active rheumatoid arthritis.

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Ann Rheum Dis 2001 Jan;60(1):61-64

Short term effects of corticosteroid pulse treatment on disease activity and the

wellbeing of patients with active rheumatoid arthritis.

s JW, Geenen R, Evers AW, van Jaarsveld CH, Kraaimaat FW, Bijlsma JW

Department of Rheumatology and Clinical Immunology, University Medical Center,

PO Box 85500, 3508 GA Utrecht, The Netherlands.

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OBJECTIVE: To investigate the short term effects of corticosteroid pulse

treatment (CPT) on disease activity, functional ability, and psychological

wellbeing of patients with active rheumatoid arthritis (RA). METHODS: Of 66

consecutive patients with active RA admitted for CPT, erythrocyte sedimentation

rate, C reactive protein level, haemoglobin concentration, platelet count,

duration of early morning stiffness, a joint score, and grip strength were

assessed before and after CPT. Additionally, a health status questionnaire was

administered. Effects of CPT were expressed as before to after intervention

effect sizes and, to place them in perspective, compared with the (long term)

effect sizes of disease modifying antirheumatic drug (DMARD) treatment in a

historical contrast group of patients with early RA. RESULTS: Statistically

significant improvement from baseline in disease activity, physical functioning,

and psychological wellbeing after CPT was seen, with moderate to large effect

sizes, resembling the effects seen after DMARD treatment. Neither depression nor

psychosis occurred during and after CPT. CONCLUSION: Qualitatively and

quantitatively the short term effects of CPT in patients with active established

RA on various dimensions of health status resemble the long term effects of

conventional DMARD treatment in patients with early RA. Psychological disorders

do not seem to be common short term side effects of CPT in patients with active

RA.

PMID: 11114284