ArticleAnnals of internal medicine2020
Risk for Serious Infection With Low-Dose Glucocorticoids in Patients With Rheumatoid Arthritis : A Cohort Study.
Article in Annals of internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
95 citing papers in PubMed, 1 synthesis or guideline pooled it, 178 citations in OpenAlex.
- European Society of Endocrinology and Endocrine Society Joint Clinical Guideline: Diagnosis and Therapy of Glucocorticoid-induced Adrenal Insufficiency.The Journal of clinical endocrinology and metabolism · 2024Guideline
- Treat-to-target strategies are feasible in elderly-onset rheumatoid arthritis given its reassuring risk-benefit profile.RMD open · 2026Trial
- Development of prediction models to select older RA patients with comorbidities for treatment with chronic low-dose glucocorticoids.Rheumatology (Oxford, England) · 2023Trial
- Prediction of mortality in pneumonia patients with connective tissue disease treated with glucocorticoids or/and immunosuppressants by machine learning.Frontiers in immunology · 2023Trial
- Waiting for JAK inhibitor safety data.RMD open · 2022Trial
- Blood Eosinophils in Chinese COPD Participants and Response to Treatment with Combination Low-Dose Theophylline and Prednisone: A Post-Hoc Analysis of the TASCS Trial.International journal of chronic obstructive pulmonary diseaseTrial
- Enterococcal pyomyositis in a rheumatoid arthritis patient under biologic therapy.Zeitschrift fur Rheumatologie · 2026Article
- Infection risk associated with steroid-sparing therapies in GCA, PMR, and ANCA-associated vasculitis: A systematic review.Joint bone spine · 2026Article
- Nonsteroid treatment options in (pulmonary) sarcoidosis. When to consider and why?Current opinion in pulmonary medicine · 2026Review
- Article
- The evolving comorbidity landscape of rheumatoid arthritis.Nature reviews. Rheumatology · 2026Review
- Effective Treatment with an Interleukin-5 Inhibitor for Recurrent Life-threatening Coronary Spastic Angina with Hypereosinophilia.Internal medicine (Tokyo, Japan) · 2026Article
- Multimorbidity and risk of infection in patients with rheumatoid arthritis: Population-based case-control study.Seminars in arthritis and rheumatism · 2026Article
- Exploring glucocorticoid dose-response patterns in VEXAS syndrome: a pilot retrospective study.Rheumatology international · 2026Review
- Immunosuppressive Medications and Nonserious Infections in People With Rheumatoid Arthritis: A Prospective Cohort Study.ACR open rheumatology · 2026Article
- Extracellular vesicles from glucocorticoids-preconditioned synovial mesenchymal stem cells exert antiarthritic effects by downregulating the mRNA m6A modification of NLRP3 in macrophages through miR-212-5p.Bioengineering & translational medicine · 2026Article
- A paradigm shift in corticosteroid therapy for sarcoidosis: a World Association of Sarcoidosis and Other Granulomatous Disorders Position Paper, endorsed by the Americas Association of Sarcoidosis and Other Granulomatous Disorders.The Lancet. Respiratory medicine · 2026Review
- Serious infection risk in older adults with RA receiving biologic or targeted synthetic DMARDs: the role of age at disease onset.Therapeutic advances in musculoskeletal disease · 2026Article
- Glucocorticoid reduction with baricitinib in rheumatoid arthritis refractory to prior therapies: a 24-week real-world analysis.Frontiers in medicine · 2026Article
- Spontaneous Pneumomediastinum in Rheumatoid Arthritis Associated Interstitial Lung Disease and Bronchiectasis: A Three-Component Pathophysiologic Framework.European journal of case reports in internal medicine · 2026Article
35 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundLow-dose glucocorticoids are frequently used for the management of rheumatoid arthritis (RA) and other chronic conditions, but the safety of long-term use remains uncertain.
objectiveTo quantify the risk for hospitalized infection with long-term use of low-dose glucocorticoids in patients with RA receiving stable disease-modifying antirheumatic drug (DMARD) therapy.
designRetrospective cohort study.
settingMedicare claims data and Optum's deidentified Clinformatics Data Mart database from 2006 to 2015. PATIENTS: Adults with RA receiving a stable DMARD regimen for more than 6 months. MEASUREMENTS: Associations between glucocorticoid dose (none, ≤5 mg/d, >5 to 10 mg/d, and >10 mg/d) and hospitalized infection were evaluated using inverse probability-weighted analyses, with 1-year cumulative incidence predicted from weighted models.
results247 297 observations were identified among 172 041 patients in Medicare and 58 279 observations among 44 118 patients in Optum. After 6 months of stable DMARD use, 47.1% of Medicare patients and 39.5% of Optum patients were receiving glucocorticoids. The 1-year cumulative incidence of hospitalized infection in Medicare patients not receiving glucocorticoids was 8.6% versus 11.0% (95% CI, 10.6% to 11.5%) for glucocorticoid dose of 5 mg or less per day, 14.4% (CI, 13.8% to 15.1%) for greater than 5 to 10 mg/d, and 17.7% (CI, 16.5% to 19.1%) for greater than 10 mg/d (all LIMITATION: Potential for residual confounding and misclassification of glucocorticoid dose.
conclusionIn patients with RA receiving stable DMARD therapy, glucocorticoids were associated with a dose-dependent increase in the risk for serious infection, with small but significant risks even at doses of 5 mg or less per day. Clinicians should balance the benefits of low-dose glucocorticoids with this potential risk. PRIMARY FUNDING SOURCE: National Institute of Arthritis and Musculoskeletal and Skin Diseases.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.