Do glucocorticoid drugs increase the risk of adverse events in patients with rheumatoid arthritis?

This study investigated adverse events associated with glucocorticoid medications in patients with rheumatoid arthritis. The study found that patients with RA have an increased incidence of adverse events associated with the use of glucocorticoids.

Treatment of rheumatoid arthritis (RA) involves taking medication to reduce inflammation. One type of drug used to treat RA are glucocorticoids (GCs). These drugs target receptors that are involved in the production of inflammatory proteins. GCs are usually prescribed in combination with other medications called DMARDs (disease-modifying drugs) that target specific inflammatory proteins.

GCs are usually used for a short period when a patient’s symptoms worsen. GCs may be associated with an increase in serious adverse events (SAEs). It is unclear if GCs are a significant risk of SAEs in patients with RA.

This study investigated the risk associated with GC use in patients with RA. This study included information on almost 68,100 patients with RA or non-RA patients (controls). Using a database, data on medication use, disease history and other important clinical information was retrieved. 

Patients with RA treated with GCs had an increased risk of SAEs including diabetes (33%), osteoporosis (41%), serious infection (28%), and stroke or heart attack (28%) compared to non-RA patients. Patients treated with GCs (both RA and non-RA) had an increased risk of SAEs compared to those that were not treated with GCs. Current use of GCs was associated with an increased risk of bowel rupture, bleeding, diabetes, serious infection, osteoporosis and death.

The authors conclude that patients with RA have an increased incidence of adverse events associated with the use of glucocorticoids.

GCs are prescribed when disease activity worsens in RA. As a result it is difficult to determine if the risk of adverse events is directly caused by GCs. An increase in disease severity may also contribute to SAEs.

If you have any concerns regarding the use of glucocorticoids please discuss this with your physician.