In a double blind placebo controlled trial, 167 RA patients (with duration of <3 years) were started on DMARD therapy (initially sulphasalazine, or an alternative DMARD if the patient discontinued sulphasalazine), in addition to either prednisolone 7 mg/day or placebo. The modified Sharp method was used to measure the primary endpoint, radiological damage. At 2 years, 73% of patients in the prednisolone group continued prednisolone and 70% continued sulphasalazine; at 2 years, 80% of patients in the placebo group continued placebo and 64% continued sulphasalazine. No significant difference in radiological damage measurements existed between the groups either at baseline or at 2 years, suggesting that low dose corticosteroids do not have a role in managing RA with DMARDs.
Capell HA, Madhok R, Hunter JA, Porter D, Morrison E, Larkin J, Thomson EA, Hampson R, Poon FW. Lack of radiological and clinical benefit over two years of low dose prednisolone for rheumatoid arthritis: results of a randomised controlled trial. Ann Rheum Dis. 2004;63(7):797-803.