Pulsed methylprednisolone in active early rheumatoid disease: a dose-ranging study

Br J Rheumatol. 1988 Jun;27(3):211-4. doi: 10.1093/rheumatology/27.3.211.


A dose-ranging, double-blind study of pulsed methylprednisolone in 71 patients with active classical or definite RA is reported. Single pulses of 40 mg, 500 mg or 1 g were administered during a 24-h admission. All patients benefited transiently, but only in those who received 1 g was this prolonged beyond 3 weeks. Laboratory measurements showed no significant change in any group. Significantly more patients in the 1 g group felt the treatment worthwhile than in the other groups. The drop-out rates in the 40 mg and 500 mg groups differed significantly from that seen in the 1 g group and were such that statistical analysis beyond 3 weeks was difficult to interpret. Side-effects were mild. Three patients subsequently developed avascular necrosis, one in the 1 g and two in the 40 mg groups. The study suggests that single doses of MP below 1 g are not helpful in the management of acute RA.

Publication types

  • Case Reports
  • Clinical Trial
  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / drug therapy*
  • Clinical Trials as Topic
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Infusions, Intravenous
  • Methylprednisolone / administration & dosage*
  • Methylprednisolone / adverse effects
  • Middle Aged
  • Osteonecrosis / chemically induced
  • Random Allocation
  • Time Factors


  • Methylprednisolone