TY - JOUR
T1 - Effect of dexamethasone on autoantibody levels and arthritis development in patients with arthralgia
T2 - A randomised trial
AU - Bos, W. H.
AU - Dijkmans, B. A.C.
AU - Boers, M.
AU - Van De Stadt, R. J.
AU - Van Schaardenburg, D.
PY - 2010/3
Y1 - 2010/3
N2 - Background: Rheumatoid arthritis is characterised by antibodies to citrullinated proteins (ACPA) and rheumatoid factor (RF) in the preclinical phase. Objective: To determine whether an intervention aimed at decreasing autoantibody levels in people at risk may be effective in preventing progression to arthritis. Methods: 83 patients with arthralgia positive for ACPA or IgM-RF were randomly allocated to intramuscular injections of 100 mg dexamethasone or placebo at baseline and 6 weeks. The primary end point was a 50% antibody reduction or normalisation at 6 months. Results: The primary end point was reached in one patient in each group. Patients treated with dexamethasone had reductions of antibody levels after 1 month (ACPA -22% and IgM-RF -14%), which persisted at 6 months for ACPA. During a median follow-up of 26 months, arthritis development in both groups was similar (20% vs 21%). Conclusion: In autoantibody-positive patients with arthralgia, dexamethasone treatment decreases ACPA and IgM-RF levels, but does not prevent arthritis development.
AB - Background: Rheumatoid arthritis is characterised by antibodies to citrullinated proteins (ACPA) and rheumatoid factor (RF) in the preclinical phase. Objective: To determine whether an intervention aimed at decreasing autoantibody levels in people at risk may be effective in preventing progression to arthritis. Methods: 83 patients with arthralgia positive for ACPA or IgM-RF were randomly allocated to intramuscular injections of 100 mg dexamethasone or placebo at baseline and 6 weeks. The primary end point was a 50% antibody reduction or normalisation at 6 months. Results: The primary end point was reached in one patient in each group. Patients treated with dexamethasone had reductions of antibody levels after 1 month (ACPA -22% and IgM-RF -14%), which persisted at 6 months for ACPA. During a median follow-up of 26 months, arthritis development in both groups was similar (20% vs 21%). Conclusion: In autoantibody-positive patients with arthralgia, dexamethasone treatment decreases ACPA and IgM-RF levels, but does not prevent arthritis development.
UR - http://www.scopus.com/inward/record.url?scp=77949456678&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/ard.2008.105767
DO - https://doi.org/10.1136/ard.2008.105767
M3 - Article
C2 - 19363022
SN - 0003-4967
VL - 69
SP - 571
EP - 574
JO - Annals of the rheumatic diseases
JF - Annals of the rheumatic diseases
IS - 3
ER -