ArticleTherapeutic advances in musculoskeletal disease2026
Predictors of intramuscular glucocorticoid bridge therapy failure in rheumatoid arthritis: a real-world observational study.
Article in Therapeutic advances in musculoskeletal disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Intramuscular glucocorticoid (GCs) bridge therapy is an equivalently recommended bridging strategy to oral GCs for rheumatoid arthritis (RA) under predefined tapering and discontinuation schemes. Objectives: We aimed to investigate the risk factors of intramuscular GCs bridge therapy failure in RA. Design: A retrospective analysis of collected data on RA patients initiating intramuscular betamethasone as bridging therapy. Methods: In this longitudinal real-world cohort study, 153 RA patients initiating intramuscular betamethasone as bridging therapy combined with csDMARDs (without concurrent biologics/JAK inhibitors) were included. Bridging strategy success under required: (1) GCs discontinuation within 3 months; (2) remission or low disease activity at discontinuation; (3) sustained control without short-term relapse post-discontinuation; (4) no transition to oral GCs and no initiation of b/tsDMARDs during the bridging period. Failure encompassed all other outcomes. Independent predictors were identified via multivariate logistic regression. Results: Among 153 patients receiving intramuscular betamethasone as bridging therapy, 94 (61.4%) experienced bridge therapy failure versus 59 (38.6%) successes. The most common mode for bridging therapy failure was transition to oral GCs ( Conclusion: High disease activity and concurrent leflunomide use at GCs initiation independently predict failure of intramuscular GCs bridge therapy in RA. Early risk stratification may optimize induction therapy selection and potentially improve bridge therapy success rates.
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