AB0403 What Is The Place of Corticosteroids in The Treatment of Patients with Early Arthritis?

BackgroundWhile the 2013 EULAR recommendations for the management of rheumatoid arthritis (RA) mention that low-dose corticosteroids (CS) should be considered as part of the initial treatment strategy in association with DMARDs and should be tapered as soon as possible (1), the 2015 ACR Guidelines for the treatment of RA recommend CS for early RA (ERA) patients only if the disease flares (2).ObjectivesThe aim of this study is to determine what forms of CS are used for patients with ERA and if the use of CS influences the outcome of this patients.MethodsWe have evaluated data obtained from patients with early arthritis (duration of less than 12 months), either ERA or early undifferentiated arthritis not classifiable as other disease, referred to the Early Arthritis Research Center of “Dr. I. Cantacuzino” between 2010 and 2014. Patients were treated according to the current guidelines. Parameters were evaluated at baseline and after 1 year of follow up.Results73 patients were enrolled in this study and 60.3% were female. The mean age was 49.81±15.93 years. The mean duration of symptoms was 3.39±3.42 months. The parameters evaluated at baseline and after 1 year of follow up (median value and interquartile range) are described in Table 1.Table 1.Parameters evaluated during the studyParameterBaseline12 monthsMedian (Interquartile range)Median (Interquartile range)CRP (mg/l)8.63 (2.63–18.44)1.91 (0.91–4.19)ESR (mm/h)27.00 (11.00–47.00)12.00 (7.00–17.00)VAS patient (mm)64.00 (52.50–76.00)15.50 (0.00–26.00)VAS physician (mm)50.00 (30.00–60.00)10.00 (0.00–10.00)DAS284.75 (3.63–5.35)1.61 (1.17–2.59)SDAI26.12 (14.94–32.13)2.67 (0.31–5.32)61.7% of patients received treatment with DMARDs and 56.2% of patients received CS, associated with DMARDs. The types of CS used at baseline and the percent of patients who received each type were: Prednisone (42.5%), Dexamethasone i.m. (4.1%), Betamethasone administered intra-articularly (8.2%) and pulse therapy with Methylprednisolone (1.4%). At 12 months only 10 patients (13.7%) still received CS and the only form of CS used was low-dose Prednisone. The number of patients who required CS decreased significantly during the study (p