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Steroids: for Rheumatoid Arthritis

- See:
      - Rheumatoid Arthritis
      - Steroids

- Discussion:
    - corticosteroids may occassionally be used to alleviate intractable joint inflammation or vasculitis in RA;
          - however, there is a risk of iatrogenic Cushing's syndrome;
    - intraarticular instillation of steroids is useful in management of disease that is worst in a single joint;
          - repeated injections increase the risk of articular cartilage damage from catabolic effects of local steroids;

- Dosage:
    - daily doses of > 5-7.5 mg of prednisone or its equivalent should be avoided because of side effects produced by glucocorticoids, especially diminishing of bone mineral content;
          - low dose (5 to 7.5 mg per day given as a single dose) may benefit certain patients with little risk of morbidity;

- Musculoskeletal Effects of Chronic Steroid Usage

Pulse steroid therapy in rheumatoid arthritis: can equivalent doses of oral prednisolone give similar clinical results to intravenous methylprednisolone

Meta-analysis of short-term low dose prednisolone versus placebo and non-steroidal anti-inflammatory drugs in rheumatoid arthritis.