Most patients stop steroid use after a short bridge to methotrexate treatment

Newly diagnosed rheumatoid arthritis often requires immediate relief from inflammation. Doctors sometimes use prednisolone, a steroid, to calm the disease quickly before starting methotrexate. The goal is to eventually stop the steroid because long-term use carries risks. This trial tested if patients could safely stop the steroid after a short period. Two hundred and twenty-seven patients received a short course of prednisolone that tapered from 15 mg down to zero over seven weeks. They then took methotrexate alone. The researchers watched these patients for two years to see if they could stay off the steroid. The results were encouraging for most people. By seven weeks, 84 percent of patients had successfully stopped taking the steroid. By three months, that number rose to 89 percent. Even after two years, 95 percent had discontinued the drug. Only a small group, about five percent, needed to keep taking prednisolone at every single check-up visit. Some patients who stopped early did restart the medication later, but 80 percent of those who quit after seven weeks stayed off it. The study supports the idea that tapering to discontinuation is achievable for most patients. This approach aligns with current recommendations from the European Alliance of Associations for Rheumatology.