iNFO - Management of early RA - summary of recommendations - steroid therapy - SIGN

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ish Intercollegiate Guidelines Network

Management of Early Rheumatoid Arthritis

Summary of recommendations

Corticosteroid therapy

Oral corticosteroids are not recommended for routine use, as there is

no sustained clinical or functional benefit and there is high risk of

toxicity with long term use.

Inform patients of the risks of corticosteroids prior to

prescription and issue steroid warning card.

Intramuscular corticosteroid allows control of dose and duration

of therapy and may be preferable to oral therapy.

Oral corticosteroids should be withdrawn slowly to avoid rebound

flare of symptoms.

The lowest possible dose of corticosteroid should be used for the

shortest possible time.

Monitor patients closely for adverse corticosteroid effects. Be alert

to the possibility of diabetes, cataract and infection. Inform patients not

previously infected of the danger of chicken pox/shingles exposure

Ensure adequate surveillance and prophylaxis of osteoporosis in

patients taking oral corticosteroids.

http://www.sign.ac.uk/guidelines/fulltext/48/summary.html

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Mayo Clinic in Rochester

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s Hopkins Medicine

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