ReviewCureus2025
Adverse Effects and Withdrawal Symptoms of Prolonged Glucocorticoid Therapy in Chronic Rheumatoid Arthritis and Systemic Lupus Erythematosus: A Systematic Review.
Review in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The objective of this systematic review was to assess adverse effects and long-term withdrawal symptoms of prolonged glucocorticoid (GC) therapy in patients with rheumatic diseases, e.g., rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The review synthesizes evidence from randomized controlled trials (RCTs), clinical trials, and observational cohorts in order to evaluate the safety and tolerability of long-term GC use and the effect of GC withdrawal strategies. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A complete literature search on PubMed, Scopus, and Google Scholar was performed using both text words and controlled vocabulary. Only RCTs and clinical trials published in English from January 1, 2020, to October 31, 2025, were included. Only RCTs and observational cohort studies were considered. RCT's methodological quality was assessed using the Cochrane Risk of Bias 2.0 (RoB 2.0) tool and non-randomized studies by the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. ROBVIS software (University of Bristol, Bristol, United Kingdom) was used to visualize the RoB. A total of 10 studies of low to moderate RoBs were considered to synthesize evidence. In conclusion, the balance of evidence strongly supports the European Alliance of Associations for Rheumatology (EULAR) recommendations to taper and discontinue GCs whenever clinically feasible. Although there is actual danger of disease flare, the evidence suggests less long-term organ damage, particularly in SLE, and prevention of multi-system adverse events, indicating a clear clinical advantage for attempting GC withdrawal. This reinforces the significance of discontinuation as a cornerstone of standard care. The findings support a gradual process of tapering as a safer and more efficient solution than sudden withdrawal. Thus, clinicians need to take into account the individual patient factors to increase the likelihood of successful discontinuation.
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Registered trials
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.