ArticleRMD open2023
Tapering glucocorticoids and risk of flare in rheumatoid arthritis on biological disease-modifying antirheumatic drugs (bDMARDs).
Article in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 20 citations in OpenAlex.
- Article
- Glucocorticoid sparing in rheumatoid arthritis patients treated with Janus kinase inhibitors: insights from the Japanese patient registry.Scientific reports · 2026Article
- Glucocorticoid reduction with baricitinib in rheumatoid arthritis refractory to prior therapies: a 24-week real-world analysis.Frontiers in medicine · 2026Article
- Glucocorticoid sparing effect of Janus kinase inhibitors compared to biologic disease modifying anti-rheumatic drugs in rheumatoid arthritis, a single-centre retrospective analysis.Rheumatology (Oxford, England) · 2025Article
- New guidelines on glucocorticoid-induced adrenal insufficiency: the end of short synacthen test in rheumatology?RMD open · 2025Article
- Unveiling novel therapeutic mechanisms of Xinfeng capsule: modulating the ALKBH5-m6A-LINC00968 axis to alleviate oxidative stress-driven NETosis in rheumatoid arthritis.Frontiers in immunology · 2025Article
- Revolutionizing rheumatoid arthritis therapy: harnessing cytomembrane biomimetic nanoparticles for novel treatment strategies.Drug delivery and translational research · 2025Review
- Unveiling difficult-to-treat rheumatoid arthritis: long-term impact of biologic or targeted synthetic DMARDs from the KOBIO registry.Arthritis research & therapy · 2023Article
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionGlucocorticoids are still a mainstream of rheumatoid arthritis (RA) treatment. Reducing glucocorticoids should be attempted in all patients. However, choosing the right tapering strategy is challenging. The primary aim of our study is to determine the dose-response association between glucocorticoid tapering and risk of flare in RA.
methodsWe conducted a case-crossover study to determine the factors associated to higher risk of flare in patients with RA. In case-crossover studies time-varying factors are assessed before events (hazard periods) and before control periods. We defined hazard periods as the 6 months immediately preceding flares of RA. Control periods were the 6 months prior to visits without flare. Exposure of interest was the tapering of glucocorticoids to various doses.
results508 patients with RA were included in the study and 267 (52.5%) had at least a flare and served as the case-crossover study population. 1545 visits were available for analysis and 345 (22.3%) flares were recorded. Discontinuation of glucocorticoids (ie, tapering to doses of 0 mg/day) and tapering to 0-2.5 mg/day was associated with higher risk of flare (adjusted OR (aOR) of 1.45, 95% CI: 1.13 to 2.24 and aOR of 1.37; 95% CI: 1.06 to 2.01, respectively). Tapering to doses >2.5 mg/day was not associated with significantly higher risk of flare.
conclusionsWe found that tapering to doses of >2.5 mg/day was generally effective in terms of risk of flare. Flare risk was higher when glucocorticoids were tapered to doses ≤2.5 mg/day. Our study might help design new tapering strategies in patients with RA on biological disease-modifying antirheumatic drugs.
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