The following is a summary of “Initial glucocorticoid bridging in rheumatoid arthritis: does it affect glucocorticoid use over time?’’ published in the August 2023 issue of Rheumatology by Ouwerkerk et al.
Researchers performed a retrospective study to compare long-term Glucocorticoid (GC) use in Rheumatoid Arthritis (RA) patients with and without Initial GC Bridging.
The study combined data from BeSt, CareRA, and COBRA trials. Using mixed-effects regression, GC usage at 12, 18, and 24 months was compared between those with and without initial GC bridging. Secondary outcomes included cumulative GC dose, DAS28 evolution, and DMARD changes up to 24 months.
Of 625 patients, 40% (252) received GC bridging. After excluding the bridging period, both groups had low subsequent GC use with similar cumulative doses. Mean DAS28 was comparable, but bridgers experienced faster improvement (p<0.001) in the initial 6 months and required fewer DMARD changes (incidence rate ratio: 0.59, (95% CI 0.38 to 0.94)). At t=12 months, GC use was higher in bridgers (OR: 3.27, 95% CI 1.06 to 10.08), resulting in a 2406 mg (95% CI 1,403 to 3,408) cumulative GC dose difference over 24 months due to bridging schedules.
The findings suggested GC bridging in RA resulted in rapid clinical improvement, fewer DMARD changes, and higher cumulative GC dose over 2 years.
Source: ard.bmj.com/content/early/2023/08/22/ard-2023-224270?rss=1