Short-term glucocorticoids reduce risk of chronic NSAID and analgesic use in early methotrexate-treated rheumatoid arthritis patients with favourable prognosis: subanalysis of the CareRA randomised controlled trial

• DOI: 10.1136/rmdopen-2021-001615
• Publication Date: 2021-05-24T15:55:14Z
• Authors: Sofia Pazmino; Annelies Boonen; Diederik De Cock; Veerle Stouten; Johan Joly; Delphine Bertrand; René Westhovens; Patrick Verschueren
• Keywords: Acetaminophen; Cobra

To explore non-steroidal anti-inflammatory drug (NSAID) and analgesic use in early rheumatoid arthritis (eRA) patients with a favourable risk profile initiating methotrexate (MTX) or without glucocorticoid (GC) bridging.Patients eRA (≤1 year) (no erosions, negative factor anticitrullinated protein antibodiesor low disease activity) the 2-year CareRA trial were randomised to MTX 15 mg step-down GC scheme (COBRA Slim), oral GCs, Tight-Step-Up (TSU). Used analgesics recorded, including frequency, start/end date indication. Chronic intake (≥90 consecutive days trial) of NSAIDs, acetaminophen, opioids tramadol antidepressants for indication musculoskeletal (MSK) pain was considered. Treatments compared using χ2 analysis variance Holm's correction multiple testing.In total, 43 COBRA Slim 47 TSU. At study inclusion, 33/43 (77%) 32/47 (68%) TSU arm had been (p=0.5). During trial, 67 NSAID used MSK 26/43 (60%) which 9/43 (21%) daily chronically (DC), while 107 43/47 (92%) patients, 25/47 (53%) DC. The total number on at any time during (p<0.01) (p=0.01) significantly different between treatment arms. Number DC NSAIDs also 6/43 (14%) 19/47 (40%).In considered have prognosis, initial bridging resulted lower chronic use.NCT01172639.