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Glucocorticoid use in psoriatic arthritis and treatment outcomes: does the gender have a role?
- Source :
- Egyptian Rheumatology & Rehabilitation; 2/27/2024, Vol. 51 Issue 1, p1-7, 7p
- Publication Year :
- 2024
-
Abstract
- Background: Systemic glucocorticoids are commonly used in practice in the treatment of psoriatic arthritis. However, authorities advise against prescribing it, primarily because of the risk of psoriasis flare-ups. The authors aimed to assess the glucocorticoid use in psoriatic arthritis (PsA), factors associated with the use of glucocorticoids and to uncover whether gender has an impact on glucocorticoid use and treatment responses. Disease-modifying antirheumatic drug (DMARD)-naive PsA patients were included in this cross-sectional study. Baseline clinical and demographic characteristics were recorded. After starting DMARD treatment, patients were followed for 2 years. The number of patients who started glucocorticoids, the clinical demographics of these patients, the duration of glucocorticoid administration, and the dose for administration were recorded. Patient outcomes and gender differences were analyzed. Disease activity was measured using the Disease Activity Scale 28 (DAS28-CRP) and the Disease Activity Index for Psoriatic Arthritis (DAPSA). Results: Fifty-five of the 141 patients (39%) received glucocorticoids at the 2-year follow-up. There was no difference between the sexes who are in remission-low disease activity (LDA) on cDMARD monotherapy (p = 0.300). Glucocorticoid usage (p = 0.660), dose (p = 0.054), and duration (p = 0.159) did not differ between male and female patients. Higher glucocorticoid doses were associated with dactylitis, higher CRP levels, higher DAS-28 and DAPSA scores, and longer (> 3 months) glucocorticoid administration. Glucocorticoid duration was longer in patients with higher TJS, SJS, serum CRP, higher DAS-28 and DAPSA scores, and higher glucocorticoid doses. Sustained remission-LDA was achieved in 16 of 55 patients after cessation of glucocorticoids and no sex difference was observed. Conclusion: Systemic glucocorticoids are commonly prescribed in PsA, and when added to treatment even for short periods and in low doses, they help achieve significant disease control. Except for axial involvement, there is no difference in treatment responses between male and female patients, making it unnecessary to make a gender distinction in the treatment algorithm. Given these findings, prospective studies are needed to evaluate glucocorticoids as a bridging treatment in PsA, such as rheumatoid arthritis. [ABSTRACT FROM AUTHOR]
- Subjects :
- GLUCOCORTICOIDS
PSORIATIC arthritis
C-reactive protein
STATISTICS
STATISTICAL power analysis
CONFIDENCE intervals
CROSS-sectional method
MANN Whitney U Test
FISHER exact test
TREATMENT effectiveness
ANTIRHEUMATIC agents
T-test (Statistics)
PEARSON correlation (Statistics)
CHI-squared test
DESCRIPTIVE statistics
QUESTIONNAIRES
SOCIODEMOGRAPHIC factors
ODDS ratio
LOGISTIC regression analysis
DATA analysis
DATA analysis software
DISEASE remission
Subjects
Details
- Language :
- English
- ISSN :
- 1110161X
- Volume :
- 51
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- Egyptian Rheumatology & Rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 175759736
- Full Text :
- https://doi.org/10.1186/s43166-024-00245-w