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This article is a response to comments on a study that investigated the effects of low-dose glucocorticoid therapy on weight and blood pressure in patients with rheumatoid arthritis. The authors performed additional analyses and found that glucocorticoid-induced weight gain was limited to the first year and then stabilized. They also addressed concerns about other adverse effects associated with long-term glucocorticoid treatment, noting that recent studies challenge the notion that low-dose glucocorticoids cause cardiovascular events, osteoporosis, or death independent of disease activity. The authors also discussed the divergence in results between their pooled analysis and another trial, and addressed concerns about the handling of missing data. [Extracted from the article]

The article reports a response after switching from prednisole to dexamethasone in three D2T-RA patients with active disease despite prednisolone. Topics discussed include possible mechanisms why response to different glucocorticoids (GCs) may vary, pharmacodynamic differences between GCs, and characteristics of 3 ACPA-positive patients switched from prednisolone to dexamethasone.