Annals of Internal MedicineThe Effect of Low-Dose Glucocorticoids Over Two Years on Weight and Blood Pressure in Rheumatoid Arthritis: Individual Patient Data From Five Randomized Trials

The Low-Down on Low-Dose Glucocorticoids: Weight Gain but No Blood Pressure Spike in RA Patients

In a comprehensive analysis pooling data from five randomized controlled trials, researchers evaluated the long-term effects of low-dose glucocorticoids on weight and blood pressure in patients with rheumatoid arthritis (RA). The study offers valuable insights into the risk profile of low-dose glucocorticoid therapy, particularly in the context of RA management.

Study Design:

• Design: Pooled analysis of 5 randomized controlled trials with 2-year interventions, allowing for concomitant treatment with disease-modifying antirheumatic drugs (DMARDs).
• Setting: Conducted across 12 European countries.
• Patients: A total of 1,112 participants were included, with a mean age of 61.4 years and 68% being women. Included both early and established RA patients.
• Intervention: Glucocorticoids at dosages of 7.5 mg or less prednisone equivalent per day.
• Measurements: Coprimary end points were changes in body weight and mean arterial pressure after 2 years, with a secondary end point assessing the change in the number of antihypertensive drugs.

Key Findings:

• Weight gain was observed in both groups, but glucocorticoid treatment led to an average 1.1 kg more weight gain than the control (P < 0.001).
• No significant difference in mean arterial pressure was observed between the groups (P = 0.187).
• No evidence of differences in the number of antihypertensive drugs between groups.

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