van Gestel A M, Laan R F, Haagsma C J, van de Putte L B, van Riel P L
Department of Rheumatology, University Hospital Nijmegen, The Netherlands.
Br J Rheumatol. 1995 Apr;34(4):347-51. doi: 10.1093/rheumatology/34.4.347.
The efficacy of oral prednisone as bridge therapy in rheumatoid arthritis (RA) was studied. Forty patients starting aurothioglucose were randomized to receive either prednisone or placebo for 18 weeks. The dose was 10 mg/day in the first 12 weeks, 7.5 mg/day in weeks 13 and 14, 5 mg/day in weeks 15 and 16, and 2.5 mg/day in weeks 17 and 18. Patients were followed for 44 weeks. We found that disease activity was significantly lower in the prednisone group as early as week 1 and continued up to week 12. Response to prednisone was noticed in 60% of the patients. After tapering prednisone, a rebound deterioration was noticed at weeks 20 and 24 in 58% of the responders. No significant differences in X-ray progression were found between the two groups. We concluded that oral prednisone (10 mg/day) significantly reduces short-term disease activity in 60% of patients with active RA. The rebound deterioration after tapering the dose means that bridge therapy with prednisone using this dose-reduction scheme is not recommended.
研究了口服泼尼松作为类风湿关节炎（RA）过渡治疗的疗效。40名开始使用金硫葡萄糖的患者被随机分为两组，分别接受泼尼松或安慰剂治疗18周。剂量在前12周为10毫克/天，第13周和第14周为7.5毫克/天，第15周和第16周为5毫克/天，第17周和第18周为2.5毫克/天。对患者进行了44周的随访。我们发现，泼尼松组的疾病活动早在第1周时就显著降低，并持续到第12周。60%的患者对泼尼松有反应。在逐渐减少泼尼松剂量后，58%有反应的患者在第20周和第24周出现了病情反弹恶化。两组在X线进展方面未发现显著差异。我们得出结论，口服泼尼松（10毫克/天）能显著降低60%活动性RA患者短期内的疾病活动度。剂量逐渐减少后出现的病情反弹恶化意味着不推荐使用这种剂量递减方案的泼尼松进行过渡治疗。
