ArticleRheumatology (Oxford, England)2026
Methylprednisolone plus MTX-based regime vs prednisone-based standard of care for GCA: a propensity score study.
Article in Rheumatology (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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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Who cites it
2 citing papers in PubMed.
- Management of glucocorticoid-induced osteoporosis in rheumatic diseases.Best practice & research. Clinical rheumatology · 2026Review
- Methylprednisolone pulses are associated with faster remission in Giant Cell Arteritis: a multicentre inception cohort study.Arthritis research & therapy · 2026Observational
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Authors and funding
14 authors.
Funding
Abstract
objectivesTreatment of GCA still requires substantial exposure to glucocorticoids (GCs), which are associated with significant toxicity. This study compares the efficacy and safety of the GC-only standard of care (SOC) with a regimen combining intravenous methylprednisolone (IVMP) pulses, MTX and lower doses of prednisone, in newly diagnosed patients with GCA.
methodsA usual clinical practice study was conducted in three Spanish academic hospitals. One hundred and fifty-one patients diagnosed with GCA were treated with SOC prednisone (40-60 mg/d) or with IVMP (125-500 mg/d ×3) followed by lower-dose prednisone (≤30 mg/d) and MTX (IVMP/MTX), with a follow-up of 2 years. A propensity score was used to adjust for baseline differences in the multivariate analyses.
resultsSeventy-nine (52.3%) patients received SOC prednisone and 72 (47.7%) IVMP/MTX. The clinical characteristics at baseline were similar in both the groups. Hundred percent patients achieved remission after a median time of 4 weeks, without differences between the groups. Relapse rates were also similar. Patients receiving IVMP/MTX had significantly lower cumulative GC doses and reached prednisone ≤5 mg/d faster than SOC patients (mean 13.8 vs 56.5 weeks; P < 0.001). Patients in the IVMP/MTX group were less likely to suffer any GC-related adverse effect (adjusted OR 0.35, 95% CI 0.14-0.85; P = 0.021).
conclusionsThe combination IVMP/MTX with lower-dose prednisone is as effective as the SOC in inducing remission and preventing relapses in GCA. The IVMP/MTX scheme significantly reduces GC exposure and GC-associated adverse effects. IVMP/MTX could be a potential GC-sparing strategy, especially in patients with GCA at higher risk of GC toxicity.
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