Pulse Methylprednisolone in Rheumatoid Arthritis

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Abstract
Ten patients with rheumatoid arthritis unresponsive to conventional therapy participated in a double-blind crossover trial in which they randomly received a pulse of 1 g methylprednisolone or placebo, i.v., once a month for 6 mo. The drug-first and placebo-first groups had the same mean American Rheumatism Association functional classification, 2.5. Patients on methylprednisolone pulses compared to placebo, showed significantly better mean tender-joint counts, walking times and grip strength (P < 0.05). The drug-treated patients had significantly lower levels of immune complexes (P < 0.01) and IgG (P < 0.01). Effects could still be measured an average of 2.9 .+-. 0.4 mo. after the last dose of methylprednisolone. No significant side effects were noted during the therapy. Despite these findings, pulse methylprednisolone did not appear to significantly retard radiologic progression of the arthritis.