The longterm effect of pulsed corticosteroids on the efficacy and toxicity of chrysotherapy in rheumatoid arthritis

J Rheumatol. 1994 Mar;21(3):435-41.


Objective: To follow those patients who participated in a randomized, double blind placebo controlled trial investigating the effect of pulse methylprednisolone treatment in 60 patients with rheumatoid arthritis (RA) starting chrysotherapy.

Methods: Following completion of the original 24-week trial, 47 of the original 60 patients were reexamined between 32 and 67 weeks after completion of the original study. Patients were assessed by a composite clinical score, the Health Assessment Questionnaire (HAQ), erythrocyte sedimentation rate, C-reactive protein and rheumatoid factor levels.

Results: At the end of the 24-week trial, the number of patients who responded well to therapy was significantly greater (p < 0.05) in the patients who had received methylprednisolone (17/30) compared with the placebo group (8/30). At the longterm followup assessment, the mean disability score (HAQ) was significantly less (p < 0.05) in patients receiving the initial steroid pulses. No significant difference in drug toxicity or the length of time that patients remained on gold, was observed between the 2 treatment groups.

Conclusion: Our study supports a beneficial adjunctive role of pulse corticosteroids in patients with RA starting gold therapy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / drug therapy*
  • Blood Sedimentation / drug effects
  • C-Reactive Protein / analysis
  • Double-Blind Method
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Gold / administration & dosage
  • Gold / therapeutic use*
  • Humans
  • Injections, Intramuscular
  • Injections, Intravenous
  • Male
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / therapeutic use*
  • Middle Aged
  • Severity of Illness Index
  • Treatment Outcome


  • Gold
  • C-Reactive Protein
  • Methylprednisolone