Corkill M M, Kirkham B W, Chikanza I C, Gibson T, Panayi G S
Rheumatology Unit, United Medical School, Guy's Hospital, London.
Br J Rheumatol. 1990 Aug;29(4):274-9. doi: 10.1093/rheumatology/29.4.274.
Fifty-nine patients commencing intramuscular sodium aurothiomalate therapy were randomized to receive three doses of 120 mg intramuscular depot methylprednisolone acetate or matching placebo at weeks 0, 4, and 8 in addition to chrysotherapy. The group receiving methylprednisolone had more rapid disease improvement. This advantage persisted for up to 12 weeks, although by 24 weeks both groups exhibited similar benefits due to continued improvement in the group treated with gold alone. Withdrawals secondary to gold-induced side-effects occurred later in the steroid group (median time to withdrawal: 15 weeks steroid; 4.5 weeks placebo, P less than 0.05), and there were fewer withdrawals due to a lack of effect in the steroid group (one steroid versus three placebo, P NS). We conclude that glucocorticoids given as intermittent, intramuscular depot injections have a significant short term benefit which can be maintained by concomitant administration of intramuscular gold.
59例开始接受硫代苹果酸金钠肌肉注射治疗的患者被随机分组，在第0、4和8周除金疗法外，分别接受3剂120mg的醋酸甲泼尼龙长效肌肉注射或匹配的安慰剂。接受甲泼尼龙的组疾病改善更快。这一优势持续长达12周，尽管到24周时，由于仅接受金治疗的组持续改善，两组表现出相似的疗效。激素组因金诱导的副作用导致的停药发生时间较晚（停药的中位时间：激素组15周；安慰剂组4.5周，P<0.05），且激素组因缺乏疗效导致的停药较少（激素组1例，安慰剂组3例，P无统计学意义）。我们得出结论，间歇性肌肉注射长效糖皮质激素有显著的短期益处，同时给予肌肉注射金可维持这一益处。
