title: Glucocorticoids in early rheumatoid arthritis: are the benefits of joint-sparing effects offset by the adverse effect of osteoporosis? the effects on bone in the utrecht study and the CAMERA-II study.
abstract: This paper reviews the clinical effects on bone of 10 mg of prednisone daily in early rheumatoid arthritis, given for 2 years in the Utrecht Study and in the second CAMERA (Computer- Assisted Management in Early Rheumatoid Arthritis) Study, and addresses the question whether there were joint-sparing effects and whether these were offset by adverse effects, especially osteoporosis. We conclude that a 2-year adjunct treatment with 10 mg of prednisone daily increases the benefits of disease-modifying antirheumatic drug therapy and has joint-sparing properties, even if added to the tight control methotrexate-based strategy aiming for remission. Importantly, with good control of inflammation and adequate use of calcium, vitamin D and bisphosphonates - according to national or international guidelines - steroid-induced osteoporosis is rare over 2 years.
authors.affiliation: Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Johannes W G
authors.initials: JW
authors.lastname: Jacobs
authors.forename: Johannes W J
authors.initials: JW
authors.lastname: Bijlsma
authors.forename: Jacob M
authors.initials: JM
authors.lastname: van Laar
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D004311:Double-Blind Method; D004360:Drug Therapy, Computer-Assisted; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007596:Joints / Q000187:drug effects*; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands; D010024:Osteoporosis / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D000889:Anti-Arrhythmia Agents; D005938:Glucocorticoids