Glucocorticoid Effect on Radiographic Progression in Placebo Arms of Rheumatoid Arthritis Biologics Trials

J Rheumatol. 2016 Jun;43(6):1024-6. doi: 10.3899/jrheum.150932. Epub 2016 Apr 1.

Abstract

Objective: To assess the effect of glucocorticoids (GC) on damage progression in placebo-biologic arms of rheumatoid arthritis (RA) biologics trials.

Methods: Posthoc metaanalysis of 2 infliximab (IFX) trials (established and early RA) and 1 tocilizumab (TCZ) trial (established RA).

Results: The proportion of patients receiving GC was 38%-64%, baseline damage was 11-82 Sharp/van der Heijde points, and progression in the placebo groups was 0.5-4.8 points in 6 months. In the pooled IFX studies, GC cotreatment reduced 6-month progression by 2.6 points (95% CI 0.6-4.5). In the TCZ study (progression rate 0.5 Genant points), no such difference was seen.

Conclusion: GC cotreatment may affect results in RA trials.

Keywords: BIOLOGICS; GLUCOCORTICOIDS; JOINT DAMAGE; METAANALYSIS; RHEUMATOID ARTHRITIS.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / diagnostic imaging
  • Arthritis, Rheumatoid / drug therapy*
  • Disease Progression
  • Drug Therapy, Combination
  • Glucocorticoids / therapeutic use*
  • Humans
  • Infliximab / therapeutic use
  • Joints / diagnostic imaging*
  • Methotrexate / therapeutic use
  • Placebos / therapeutic use*
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Glucocorticoids
  • Placebos
  • Infliximab
  • tocilizumab
  • Methotrexate